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General NPI Number Information
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NPI Number | 1629503339
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Entity Type | Organization
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Legal Business Name | RWJBARNABAS
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Dates
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Enumeration Date | 05/01/2017
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 200 S ORANGE AVE SUITE NUMBER 112
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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 | 973-322-6457
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Fax |
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Provider Business Mailing Address
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Address Line | 200 MOUNT PLEASANT AVE APT K9
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City | WEST ORANGE
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State | NJ
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Zip | 07052-4049
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Country | US
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Telephone | 973-699-7963
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Fax |
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Authorized Official
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Title or Position | GERIATRIC
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Name | MS. FLORENCE SMITH
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Credential | ANP
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Telephone | 973-699-7963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 454832340
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License Number State | NJ
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