Healthcare Provider Details

I. General information

NPI: 1376024075
Provider Name (Legal Business Name): RWJ BARNABASHEALTH - JERSEY CITY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2018
Last Update Date: 08/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 JFK BLVD
JERSEY CITY NJ
07302
US

IV. Provider business mailing address

355 GRAND STREET
JERSEY CITY NJ
07302
US

V. Phone/Fax

Practice location:
  • Phone: 201-915-2845
  • Fax: 201-915-2440
Mailing address:
  • Phone: 201-915-2000
  • Fax: 201-915-2029

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. ROBERT VALENTINE
Title or Position: CFO
Credential:
Phone: 201-521-5920