Provider Demographics
NPI:1699955153
Name:ROXBURY TOWNSHIP HEALTH DEPT
Entity type:Organization
Organization Name:ROXBURY TOWNSHIP HEALTH DEPT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:A
Authorized Official - Last Name:GRISI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-448-2029
Mailing Address - Street 1:72 EYLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SUCCASUNNA
Mailing Address - State:NJ
Mailing Address - Zip Code:07876-1622
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:72 EYLAND AVE
Practice Address - Street 2:
Practice Address - City:SUCCASUNNA
Practice Address - State:NJ
Practice Address - Zip Code:07876-1622
Practice Address - Country:US
Practice Address - Phone:973-448-2028
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ174693Medicare PIN