Healthcare Provider Details

I. General information

NPI: 1811055569
Provider Name (Legal Business Name): ROBERT WOOD JOHNSON HEALTH NETWORK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 10/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PATTERSON ST
NEW BRUNSWICK NJ
08903
US

IV. Provider business mailing address

PO BOX 2601
NEW BRUNSWICK NJ
08903
US

V. Phone/Fax

Practice location:
  • Phone: 732-418-8055
  • Fax: 732-418-8058
Mailing address:
  • Phone: 732-418-8055
  • Fax: 732-418-8058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberNTDOH ROBE00500
License Number StateNJ

VIII. Authorized Official

Name: MR. MICHAEL ANTONIADES
Title or Position: VICE PRESIDENT
Credential:
Phone: 732-937-8525