Healthcare Provider Details

I. General information

NPI: 1700884954
Provider Name (Legal Business Name): SAINT BARNABAS OUTPATIENT CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date: 05/24/2006
Reactivation Date: 08/16/2006

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 TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number22223
License Number StateNJ

VIII. Authorized Official

Name: THOMAS J. GIBNEY
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 973-322-7286