Provider Demographics
NPI:1023148178
Name:COUNTY OF MIDDLESEX
Entity type:Organization
Organization Name:COUNTY OF MIDDLESEX
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LESTER
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:HO
Authorized Official - Phone:732-745-3121
Mailing Address - Street 1:35 KENNEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-1250
Mailing Address - Country:US
Mailing Address - Phone:732-745-3121
Mailing Address - Fax:732-745-3922
Practice Address - Street 1:35 KENNEDY BLVD
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-1250
Practice Address - Country:US
Practice Address - Phone:732-745-3121
Practice Address - Fax:732-745-3922
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF MIDDLESEX
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-07
Last Update Date:2016-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ217742OtherMEDICARE PTAN