Healthcare Provider Details

I. General information

NPI: 1609945963
Provider Name (Legal Business Name): HOLY NAME MEDICAL CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 TEANECK RD
TEANECK NJ
07666-4245
US

IV. Provider business mailing address

718 TEANECK RD
TEANECK NJ
07666-4245
US

V. Phone/Fax

Practice location:
  • Phone: 201-833-3000
  • Fax: 201-833-4486
Mailing address:
  • Phone: 201-833-3000
  • Fax: 201-833-4486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number10205
License Number StateNJ

VIII. Authorized Official

Name: DOUG ZEHNER
Title or Position: CFO
Credential:
Phone: 201-833-7016