Provider Demographics
NPI:1447596481
Name:MERIDIAN HOSPITALS CORPORATION DBA JSUMV
Entity Type:Organization
Organization Name:MERIDIAN HOSPITALS CORPORATION DBA JSUMV
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST II
Authorized Official - Prefix:DR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LAU
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:732-776-2325
Mailing Address - Street 1:1945 ROUTE 33
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-4859
Mailing Address - Country:US
Mailing Address - Phone:732-776-2325
Mailing Address - Fax:
Practice Address - Street 1:1945 ROUTE 33
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4859
Practice Address - Country:US
Practice Address - Phone:732-776-2325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-19
Last Update Date:2012-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital