MEDICARE: JERSEY SHORE MEDICAL CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282NC2000X	Children's Hospital	25MA08794900	NJ

General Provider Information

NPI Number	:	1881909323
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JERSEY SHORE MEDICAL CENTER

Provider Business Mailing Address
First Line	:	1945,CORLIES AVE
Second Line	:	ROUTE 33
City	:	NEPTUNE CITY
State	:	NJ
Zip	:	07754
Country	:	US
Telephone Number	:	732-325-7823
Fax Number	:

Provider Business Practice Location Address
First Line	:	1945 CORLIES AVE
Second Line	:	ROUTE 33
City	:	NEPTUNE CITY
State	:	NJ
Zip	:	07753-4859
Country	:	US
Telephone Number	:	732-776-4267
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	DR. PAUL SCHWARTZBERG
Credential	:	DO
Telephone Number	:	732-776-4865

Provider Enumeration Date	:	08/09/2010
Last Update Date	:	08/09/2010

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