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General NPI Number Information
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NPI Number | 1306273644
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Entity Type | Organization
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Legal Business Name | NORTH STAR HEALTH SYSTEMS
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Dates
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Enumeration Date | 10/01/2013
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Last Update Date | 10/01/2013
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Provider Practice Location Address
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Address Line | 354 AVENUE C
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City | BAYONNE
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State | NJ
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Zip | 07002-1412
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Country | US
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Telephone | 201-535-5959
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Fax | 201-535-5961
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Provider Business Mailing Address
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Address Line | 354 AVENUE C
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City | BAYONNE
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State | NJ
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Zip | 07002-1412
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Country | US
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Telephone | 201-535-5959
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Fax | 201-535-5961
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. PAUL HRISO
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Credential | MD
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Telephone | 201-320-5844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 2000577
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License Number State | NJ
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