1316089360 NPI number — MCAULEY HALL INC

Table of content: (NPI 1316089360)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316089360 NPI number — MCAULEY HALL INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MCAULEY HALL INC
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:
Provider Other Organization Name Type Code:
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:
1316089360
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/13/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1633 HIGHWAY 22 WEST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WATCHUNG
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07069-6588
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-754-3663
Provider Business Mailing Address Fax Number:
908-754-3502

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1633 US HIGHWAY 22
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WATCHUNG
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07069-6505
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-754-3663
Provider Business Practice Location Address Fax Number:
908-754-3502
Provider Enumeration Date:
02/13/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GORMLEY
Authorized Official First Name:
MARY
Authorized Official Middle Name:
IRENE
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
908-754-3663

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  061813 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 6329209 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".