Provider Demographics
NPI:1174680698
Name:ST. CLARE'S HOSPITAL
Entity Type:Organization
Organization Name:ST. CLARE'S HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR CLINICIAN
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:J
Authorized Official - Last Name:REETH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-401-2161
Mailing Address - Street 1:162 ASHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-2303
Mailing Address - Country:US
Mailing Address - Phone:973-401-2161
Mailing Address - Fax:973-401-2137
Practice Address - Street 1:100 E HANOVER AVE
Practice Address - Street 2:
Practice Address - City:CEDAR KNOLLS
Practice Address - State:NJ
Practice Address - Zip Code:07927-2020
Practice Address - Country:US
Practice Address - Phone:973-401-2161
Practice Address - Fax:973-401-2137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283Q00000XHospitalsPsychiatric Hospital