Provider Demographics
NPI:1033498951
Name:ST. JOSEPH'S REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:ST. JOSEPH'S REGIONAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN/PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHEAL
Authorized Official - Middle Name:
Authorized Official - Last Name:DELISI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-754-4100
Mailing Address - Street 1:1135 BROAD STREET, SUITE 201
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013
Mailing Address - Country:US
Mailing Address - Phone:973-754-4100
Mailing Address - Fax:
Practice Address - Street 1:1135 BROAD ST STE 201
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3346
Practice Address - Country:US
Practice Address - Phone:973-754-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-09
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital