Provider Demographics
NPI:1235378886
Name:COMMUNITY HOSPITAL GROUP, INC
Entity Type:Organization
Organization Name:COMMUNITY HOSPITAL GROUP, INC
Other - Org Name:JFK THORACIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TONI
Authorized Official - Middle Name:
Authorized Official - Last Name:AUGUSTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-632-1571
Mailing Address - Street 1:80 JAMES ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-3938
Mailing Address - Country:US
Mailing Address - Phone:732-632-1571
Mailing Address - Fax:732-632-1644
Practice Address - Street 1:80 JAMES ST
Practice Address - Street 2:4TH FLOOR
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08820-3938
Practice Address - Country:US
Practice Address - Phone:732-632-1571
Practice Address - Fax:732-632-1644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-05
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ11201174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty