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General NPI Number Information
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NPI Number | 1164510400
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Entity Type | Organization
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Legal Business Name | RUTGERS HEALTH-RWJ PEDIATRIC CRITICAL CARE
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Dates
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Enumeration Date | 10/11/2006
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Last Update Date | 11/04/2019
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Provider Practice Location Address
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Address Line | 1 ROBERT WOOD JOHNSON PL
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City | NEW BRUNSWICK
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State | NJ
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Zip | 08901-1928
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Country | US
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Telephone | 732-235-7900
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Fax | 732-235-9340
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Provider Business Mailing Address
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Address Line | 66 WEST GILBERT ST
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City | RED BANK
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State | NJ
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Zip | 07701
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Country | US
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Telephone | 732-212-0051
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Fax | 732-212-0713
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Authorized Official
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Title or Position | SR DIRECTOR OF REVENUE CYCLE
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Name | NANCY D BRADY
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Credential |
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Telephone | 732-235-6066
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0203X
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Taxonomy Name | Pediatric Critical Care Medicine Physician
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License Number |
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License Number State |
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