Healthcare Provider Details

I. General information

NPI: 1861527673
Provider Name (Legal Business Name): JERSEY SHORE UNIVERSITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 STATE ROUTE 35 N
NEPTUNE NJ
07753-4604
US

IV. Provider business mailing address

103 10TH AVE APT 5
BELMAR NJ
07719-2362
US

V. Phone/Fax

Practice location:
  • Phone: 732-869-2788
  • Fax:
Mailing address:
  • Phone: 732-859-9639
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code284300000X
TaxonomySpecial Hospital
License Number
License Number State

VIII. Authorized Official

Name: PETER SILVA
Title or Position: SUPERVISOR
Credential: LCSW
Phone: 732-869-2788