Healthcare Provider Details

I. General information

NPI: 1720036577
Provider Name (Legal Business Name): SBMC DEPARTMENT OF CRITICAL CARE MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 OLD SHORT HILLS RD
LIVINGSTON NJ
07039-5672
US

IV. Provider business mailing address

PO BOX 18979
NEWARK NJ
07191-8979
US

V. Phone/Fax

Practice location:
  • Phone: 973-322-9964
  • Fax: 973-322-9741
Mailing address:
  • Phone: 732-557-7160
  • Fax: 732-557-7109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. ANTHONY ESPOSITO
Title or Position: DIRECTOR
Credential:
Phone: 732-557-7160