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General NPI Number Information
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NPI Number | 1750794061
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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 | 06/04/2014
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Last Update Date | 06/04/2014
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Provider Practice Location Address
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Address Line | 119 E 13TH ST
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City | LINDEN
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State | NJ
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Zip | 07036-3314
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Country | US
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Telephone | 908-265-2499
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Fax |
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Provider Business Mailing Address
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Address Line | 119 E 13TH ST
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City | LINDEN
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State | NJ
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Zip | 07036-3314
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Country | US
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Telephone | 908-265-2499
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | MS. ELISA JACOBSON
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Credential | LCSW
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Telephone | 908-994-7288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | 44SL05804200
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License Number State | NJ
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