Healthcare Provider Details

I. General information

NPI: 1649311366
Provider Name (Legal Business Name): SOMERSET MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2007
Last Update Date: 09/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 REHILL AVE ATTENTION: SOMERSET FAMILY PRACTICE
SOMERVILLE NJ
08876-2598
US

IV. Provider business mailing address

110 REHILL AVE ADMINISTRATIVE OFFICE, ATTENTION CFO
SOMERVILLE NJ
08876-2598
US

V. Phone/Fax

Practice location:
  • Phone: 908-685-2900
  • Fax: 908-685-2891
Mailing address:
  • Phone: 908-595-2682
  • Fax: 908-685-2894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2080S0012X
TaxonomyPediatric Sleep Medicine Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. CARL W. O'BRIEN
Title or Position: SENIOR VICE PRESIDENT-FINANCE, CFO
Credential:
Phone: 908-595-2682