Healthcare Provider Details

I. General information

NPI: 1740428770
Provider Name (Legal Business Name): JERSEY CITY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2009
Last Update Date: 04/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 GRAND ST EXECUTIVE OFFICE
JERSEY CITY NJ
07302-4321
US

IV. Provider business mailing address

355 GRAND ST EXECUTIVE OFFICE
JERSEY CITY NJ
07302-4321
US

V. Phone/Fax

Practice location:
  • Phone: 201-915-2000
  • Fax: 201-770-3750
Mailing address:
  • Phone: 201-915-2000
  • Fax: 201-770-3750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. PAUL GOLDBERG
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 201-521-5920