Healthcare Provider Details

I. General information

NPI: 1326045550
Provider Name (Legal Business Name): HAMILTON PARK HEALTH CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 03/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 MONMOUTH ST
JERSEY CITY NJ
07302-1527
US

IV. Provider business mailing address

525 MONMOUTH ST
JERSEY CITY NJ
07302-1527
US

V. Phone/Fax

Practice location:
  • Phone: 201-653-8800
  • Fax: 201-239-8502
Mailing address:
  • Phone: 201-653-8800
  • Fax: 201-239-8502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number060906
License Number StateNJ

VIII. Authorized Official

Name: MRS. LORRAINE MOCCO
Title or Position: OWNER
Credential:
Phone: 201-653-8800