Provider Demographics
NPI:1326045550
Name:HAMILTON PARK HEALTH CARE CENTER
Entity Type:Organization
Organization Name:HAMILTON PARK HEALTH CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORRAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MOCCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-653-8800
Mailing Address - Street 1:525 MONMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-1527
Mailing Address - Country:US
Mailing Address - Phone:201-653-8800
Mailing Address - Fax:201-239-8502
Practice Address - Street 1:525 MONMOUTH ST
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-1527
Practice Address - Country:US
Practice Address - Phone:201-653-8800
Practice Address - Fax:201-239-8502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-01
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ060906314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ315300Medicare Oscar/Certification
NJ0625550001Medicare NSC