Provider Demographics
NPI:1487058871
Name:COLTS NECK HEALTH DEPARTMENT
Entity type:Organization
Organization Name:COLTS NECK HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOOKKEEPER /HRC
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:J
Authorized Official - Last Name:IPPOLITO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-493-9520
Mailing Address - Street 1:124 CEDAR DR
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-1673
Mailing Address - Country:US
Mailing Address - Phone:732-493-9520
Mailing Address - Fax:732-493-9525
Practice Address - Street 1:124 CEDAR DR
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-1673
Practice Address - Country:US
Practice Address - Phone:732-493-9520
Practice Address - Fax:732-493-9525
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWNSHIP OF COLTS NECK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-10-15
Last Update Date:2014-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ52MA04082500251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare