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NPI Code Detail

MEDICARE: CLARA MAASS MEDICAL CENTER

MEDICARE: CLARA MAASS MEDICAL CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility10909NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000654OTHERNJHORIZON SUB-ACUTE CONTRCT

General Provider Information

NPI Number : 1477675338
Entity Type Code : Organization
Provider Name (Legal Business Name) : CLARA MAASS MEDICAL CENTER
Provider Business Mailing Address
First Line : 206 BERGEN AVE
Second Line :
City : KEARNY
State : NJ
Zip : 07032-3324
Country : US
Telephone Number : 973-450-2908
Fax Number : 973-844-4705
Provider Business Practice Location Address
First Line : 206 BERGEN AVE
Second Line :
City : KEARNY
State : NJ
Zip : 07032-3324
Country : US
Telephone Number : 973-450-2908
Fax Number : 973-844-4705
Authorized Official
Title or Position : MANAGER
Name : DAVE SWEENEY
Credential :
Telephone Number : 908-851-8355
Provider Enumeration Date : 04/04/2007
Last Update Date : 08/22/2020

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Directions to “CLARA MAASS MEDICAL CENTER ” Practice Location

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