1225180144 NPI number — CITY OF BAYONNE

Table of content: (NPI 1225180144)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225180144 NPI number — CITY OF BAYONNE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF BAYONNE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BAYONNE WOMEN'S HEALTH CENTER
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225180144
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
564 BROADWAY
Provider Second Line Business Mailing Address:
2ND FLOOR
Provider Business Mailing Address City Name:
BAYONNE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07002
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-823-1250
Provider Business Mailing Address Fax Number:
201-823-1140

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
564 BROADWAY
Provider Second Line Business Practice Location Address:
2ND FLOOR
Provider Business Practice Location Address City Name:
BAYONNE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07002
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
201-823-1250
Provider Business Practice Location Address Fax Number:
201-823-1140
Provider Enumeration Date:
01/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LOMBARDI
Authorized Official First Name:
CATHERINE
Authorized Official Middle Name:
ANNE
Authorized Official Title or Position:
CLINIC COORDINATOR
Authorized Official Telephone Number:
201-823-1250

Provider Taxonomy Codes

  • Taxonomy code: 261QA0005X , with the licence number:  70993 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LW0102X , with the licence number: 26NN10250000 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 8488606 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001710801 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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