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General NPI Number Information
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NPI Number | 1356429781
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Entity Type | Organization
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Legal Business Name | SAINT BARNABAS MEDICAL CENTER
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 06/15/2009
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Provider Practice Location Address
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Address Line | 200 S ORANGE AVE PEDIATRIC SPECIALTY CENTER
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City | LIVINGSTON
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State | NJ
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Zip | 07039-5817
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Country | US
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Telephone | 973-322-7620
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Fax | 973-322-7504
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Provider Business Mailing Address
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Address Line | 200 SOUTH ORANGE AVE
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City | LIVINGSTON
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State | NJ
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Zip | 07078
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Country | US
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Telephone | 973-322-7620
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Fax | 973-322-7504
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. DEBRA SHAPIRO GILL
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Credential | PH.D.
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Telephone | 973-322-7620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | 35SI00434100
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License Number State | NJ
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