Healthcare Provider Details

I. General information

NPI: 1912996182
Provider Name (Legal Business Name): ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 E LINDSLEY RD
CEDAR GROVE NJ
07009-1152
US

IV. Provider business mailing address

315 E LINDSLEY RD
CEDAR GROVE NJ
07009
US

V. Phone/Fax

Practice location:
  • Phone: 973-754-4856
  • Fax: 973-812-4491
Mailing address:
  • Phone: 973-754-4856
  • Fax: 973-812-4491

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number060737
License Number StateNJ

VIII. Authorized Official

Name: MRS. DEBORAH QUINN MARTONE
Title or Position: ADMINISTRATOR
Credential: LNHA
Phone: 973-754-4856