Healthcare Provider Details

I. General information

NPI: 1689898306
Provider Name (Legal Business Name): MUHLENBERG REGIONAL MEDICAL CTR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PARK AVE AND RANDOLPH RD
PLAINFIELD NJ
07061-3902
US

IV. Provider business mailing address

80 JAMES ST 4TH FL
EDISON NJ
08820-3938
US

V. Phone/Fax

Practice location:
  • Phone: 732-632-1571
  • Fax: 732-632-1644
Mailing address:
  • Phone: 732-632-1571
  • Fax: 732-632-1644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number12004
License Number StateNJ

VII. Legacy identifiers

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

VIII. Authorized Official

Name: MR. RICHARD C SMITH
Title or Position: CFO
Credential:
Phone: 732-321-7000