Healthcare Provider Details

I. General information

NPI: 1649411042
Provider Name (Legal Business Name): NEW JERSEY VETERANS MEMORIAL HOME PARAMUS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2009
Last Update Date: 03/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 VETERANS WAY
PARAMUS NJ
07652-4100
US

IV. Provider business mailing address

1 VETERANS WAY
PARAMUS NJ
07652-4100
US

V. Phone/Fax

Practice location:
  • Phone: 201-634-8212
  • Fax:
Mailing address:
  • Phone: 201-634-8212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number26NJ00163800
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier26NJ00163800
Identifier TypeOTHER
Identifier StateNJ
Identifier IssuerLICENSE NUMBER

VIII. Authorized Official

Name: MRS. ROSEMARY BYRNE GREENBAUM
Title or Position: APN
Credential: APN
Phone: 201-634-8212