Healthcare Provider Details

I. General information

NPI: 1255642765
Provider Name (Legal Business Name): SAINT JOSEPH'S REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2010
Last Update Date: 06/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

88A WABENO AVE
SPRINGFIELD NJ
07081-1819
US

IV. Provider business mailing address

88A WABENO AVE
SPRINGFIELD NJ
07081-1819
US

V. Phone/Fax

Practice location:
  • Phone: 908-887-2724
  • Fax:
Mailing address:
  • Phone: 908-887-2724
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code283XC2000X
TaxonomyChildren's Rehabilitation Hospital
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code281PC2000X
TaxonomyChildren's Chronic Disease Hospital
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name: DR. THOMAS DALEY
Title or Position: PROGRAM DIRECTOR
Credential: M.D
Phone: 973-754-2543