Provider Demographics
NPI:1164412573
Name:ST JOSEPHS HOSPITAL AND MEDICAL CENTER
Entity Type:Organization
Organization Name:ST JOSEPHS HOSPITAL AND MEDICAL CENTER
Other - Org Name:ST JOSEPHS REGIONAL MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-754-2016
Mailing Address - Street 1:703 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07503-2621
Mailing Address - Country:US
Mailing Address - Phone:973-754-2000
Mailing Address - Fax:973-754-2149
Practice Address - Street 1:11 GETTY AVE
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503-2806
Practice Address - Country:US
Practice Address - Phone:973-569-6400
Practice Address - Fax:973-569-6401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-26
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ11605261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4136403Medicaid
NJ4136403Medicaid