Provider Demographics
NPI:1538582432
Name:RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY
Entity type:Organization
Organization Name:RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LARA
Authorized Official - Middle Name:
Authorized Official - Last Name:DELMOLINI-GATLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:848-932-4500
Mailing Address - Street 1:151 RYDERS LANE
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901
Mailing Address - Country:US
Mailing Address - Phone:848-932-4500
Mailing Address - Fax:732-932-3095
Practice Address - Street 1:151 RYDERS LANE
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901
Practice Address - Country:US
Practice Address - Phone:848-932-4500
Practice Address - Fax:732-932-3095
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RUTGERS, THE STATE UNIVERSITY OF NEW JERSEY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-01-28
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health