Provider Demographics
NPI:1275962375
Name:ESSEX COUNTY HOSPITAL CENTER
Entity Type:Organization
Organization Name:ESSEX COUNTY HOSPITAL CENTER
Other - Org Name:ESSEX COUNTY SPECIAL CHILD HEALTH SVCS
Other - Org Type:Other Name
Authorized Official - Title/Position:FISCAL ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:HANDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-395-4662
Mailing Address - Street 1:50 S CLINTON ST
Mailing Address - Street 2:SUITE 4300
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-3120
Mailing Address - Country:US
Mailing Address - Phone:973-395-8455
Mailing Address - Fax:973-395-8897
Practice Address - Street 1:50 S CLINTON ST
Practice Address - Street 2:SUITE 4300
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-3120
Practice Address - Country:US
Practice Address - Phone:973-395-8455
Practice Address - Fax:973-395-8897
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF ESSEX
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-08
Last Update Date:2013-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0061808Medicaid