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General NPI Number Information
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NPI Number | 1720363955
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Entity Type | Organization
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Legal Business Name | TRINITAS REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 10/19/2011
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Last Update Date | 10/19/2011
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Provider Practice Location Address
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Address Line | 901 N WOOD AVE
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City | LINDEN
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State | NJ
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Zip | 07036-4039
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Country | US
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Telephone | 908-925-2422
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Fax | 908-925-4435
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Provider Business Mailing Address
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Address Line | 901 N WOOD AVE
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City | LINDEN
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State | NJ
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Zip | 07036-4039
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Country | US
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Telephone | 908-925-2422
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Fax | 908-925-4435
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MR. THOMAS J SAMPSON
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Credential |
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Telephone | 908-298-0579
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 25MA08379100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MB06715700
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License Number State | NJ
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