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General NPI Number Information
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NPI Number | 1497825665
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Entity Type | Organization
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Legal Business Name | JERSEY CITY MEDICAL CENTER
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 355 GRAND STREET EXECUTIVE OFFICE
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City | JERSEY CITY
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State | NJ
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Zip | 07302-4321
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Country | US
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Telephone | 201-770-3712
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Fax | 732-923-2272
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Provider Business Mailing Address
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Address Line | 355 GRAND STREET EXECUTIVE OFFICE
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City | JERSEY CITY
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State | NJ
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Zip | 07302-4321
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Country | US
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Telephone | 201-770-3712
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Fax | 201-770-3750
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Authorized Official
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Title or Position | CEO
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Name | MR. MICHAEL PRILUTSKY
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Credential |
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Telephone | 201-915-2262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273R00000X
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Taxonomy Name | Psychiatric Hospital Unit
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License Number | 10904
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License Number State | NJ
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