Healthcare Provider Details

I. General information

NPI: 1053576678
Provider Name (Legal Business Name): HUMC OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2008
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 WILLOW AVE
HOBOKEN NJ
07030-3808
US

IV. Provider business mailing address

308 WILLOW AVE
HOBOKEN NJ
07030-3808
US

V. Phone/Fax

Practice location:
  • Phone: 201-418-1000
  • Fax: 201-418-1053
Mailing address:
  • Phone: 201-418-1000
  • Fax: 201-418-1053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number10908
License Number StateNJ

VIII. Authorized Official

Name: FRANK RODRIGUEZ
Title or Position: SYSTEM DIRECTOR OF MEDICAL STAFF
Credential:
Phone: 201-821-8717