Provider Demographics
NPI:1447457577
Name:BOROUGH OF SOMERVILLE
Entity type:Organization
Organization Name:BOROUGH OF SOMERVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTH OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:KRAJEWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:908-725-2300
Mailing Address - Street 1:PO BOX 399
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-0399
Mailing Address - Country:US
Mailing Address - Phone:908-725-2300
Mailing Address - Fax:908-725-2859
Practice Address - Street 1:25 W END AVE
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08876-1808
Practice Address - Country:US
Practice Address - Phone:908-725-2300
Practice Address - Fax:908-725-2859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
427824Medicare ID - Type Unspecified