Provider Demographics
NPI:1588665491
Name:ATLANTIC COUNTY PUBLIC HEALTH DEPARTMENT
Entity type:Organization
Organization Name:ATLANTIC COUNTY PUBLIC HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:609-645-7700
Mailing Address - Street 1:616 W VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1323
Mailing Address - Country:US
Mailing Address - Phone:609-601-1763
Mailing Address - Fax:609-272-8490
Practice Address - Street 1:201 SHORE RD
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-2319
Practice Address - Country:US
Practice Address - Phone:609-645-7700
Practice Address - Fax:609-272-8490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN09780200251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJUNKNOWNMedicare ID - Type UnspecifiedWITH DR. PHILIP PAPARONE