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General NPI Number Information
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NPI Number | 1942217054
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Entity Type | Organization
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Legal Business Name | RUTGERS HEALTH - UNIVERSITY BEHAVIORAL HEALTH CARE
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 07/31/2017
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Provider Practice Location Address
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Address Line | 671 HOES LN
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City | PISCATAWAY
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State | NJ
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Zip | 08854-5627
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Country | US
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Telephone | 732-235-3493
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Fax | 732-235-2101
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Provider Business Mailing Address
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Address Line | 671 HOES LN P.O. BOX 1392
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City | PISCATAWAY
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State | NJ
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Zip | 08854-5627
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Country | US
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Telephone | 732-235-3493
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Fax | 732-235-2101
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Authorized Official
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Title or Position | CFO
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Name | MR. CARL W. O'BRIEN
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Credential |
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Telephone | 732-235-5940
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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 | 22328
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License Number State | NJ
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