Healthcare Provider Details

I. General information

NPI: 1790747491
Provider Name (Legal Business Name): SAINT BARNABAS OUTPATIENT CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 05/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S ORANGE AVE
LIVINGSTON NJ
07039-5817
US

IV. Provider business mailing address

1050 GALLOPING HILL RD
UNION NJ
07083-7983
US

V. Phone/Fax

Practice location:
  • Phone: 973-322-7850
  • Fax: 973-322-7594
Mailing address:
  • Phone: 908-206-2230
  • Fax: 908-206-2237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM1200X
TaxonomyMagnetic Resonance Imaging (MRI) Clinic/Center
License Number70786
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code261QR0206X
TaxonomyMammography Clinic/Center
License Number70786
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number70786
License Number StateNJ

VIII. Authorized Official

Name: MR. GREGORY A. ALBAN
Title or Position: ASSISTANT VICE PRESIDENT OF FINANCE
Credential:
Phone: 973-322-7331