Healthcare Provider Details

I. General information

NPI: 1043457955
Provider Name (Legal Business Name): NEWARK BETH ISRAEL MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2009
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 LYONS AVE
NEWARK NJ
07112-2027
US

IV. Provider business mailing address

201 LYONS AVE
NEWARK NJ
07112-2027
US

V. Phone/Fax

Practice location:
  • Phone: 732-923-5000
  • Fax: 732-923-2272
Mailing address:
  • Phone: 732-923-5000
  • Fax: 973-926-8371

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number10709
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: MR. DARRELL TERRY
Title or Position: CEO
Credential:
Phone: 923-926-7850