Provider Demographics
NPI:1114975166
Name:COUNTY OF ESSEX
Entity Type:Organization
Organization Name:COUNTY OF ESSEX
Other - Org Name:ESSEX COUNTY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR HEALTH & REHAB
Authorized Official - Prefix:
Authorized Official - First Name:LUICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GUARINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-571-2800
Mailing Address - Street 1:204 GROVE AVE
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:07009-1436
Mailing Address - Country:US
Mailing Address - Phone:973-571-2800
Mailing Address - Fax:
Practice Address - Street 1:204 GROVE AVE
Practice Address - Street 2:
Practice Address - City:CEDAR GROVE
Practice Address - State:NJ
Practice Address - Zip Code:07009-1436
Practice Address - Country:US
Practice Address - Phone:973-571-2800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF ESSEX
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-04
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ50706207W00000X, 2084N0400X, 208800000X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ153641Medicare PIN