Healthcare Provider Details

I. General information

NPI: 1306273644
Provider Name (Legal Business Name): NORTH STAR HEALTH SYSTEMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2013
Last Update Date: 10/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

354 AVENUE C
BAYONNE NJ
07002-1412
US

IV. Provider business mailing address

354 AVENUE C
BAYONNE NJ
07002-1412
US

V. Phone/Fax

Practice location:
  • Phone: 201-535-5959
  • Fax: 201-535-5961
Mailing address:
  • Phone: 201-535-5959
  • Fax: 201-535-5961

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number2000577
License Number StateNJ

VIII. Authorized Official

Name: DR. PAUL HRISO
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 201-320-5844