Provider Demographics
NPI:1497825665
Name:JERSEY CITY MEDICAL CENTER
Entity Type:Organization
Organization Name:JERSEY CITY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:PRILUTSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-915-2262
Mailing Address - Street 1:355 GRAND STREET
Mailing Address - Street 2:EXECUTIVE OFFICE
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-4321
Mailing Address - Country:US
Mailing Address - Phone:201-770-3712
Mailing Address - Fax:201-770-3750
Practice Address - Street 1:355 GRAND ST
Practice Address - Street 2:EXECUTIVE OFFICE
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-4321
Practice Address - Country:US
Practice Address - Phone:201-770-3709
Practice Address - Fax:201-770-3750
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RWJ BARNABAS HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-08
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ10904273R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ49068OtherHORIZON NJ HLTHCARE MERCY
NH1015750OtherHORIZON NJ HLTHCARE MERCY
NJ4139801Medicaid
NJ7662904Medicaid
NJ4139801OtherCHARITY CARE UNYSIS
NJ1015751OtherHORIZON NJ HLTHCARE MERCY
NJ50022OtherAMERIGROUP AMERIHEALTH
NJ0014014OtherAETNA US HEALTHCARE
NJ310074OtherHORIZON BLUE CROSS
NJ4547900Medicaid
NJH05253OtherOXFORD HEALTH
NJHU0000048-03OtherAMERICHOICE MHS
NJ1015749OtherHORIZON NJ HLTHCARE MERCY
NJ310074OtherANTHEM GROUP NEW JERSEY
NJJ30888OtherHEALTH NET PHS
NJ0004312000OtherAMERIHEALTH
31S074Medicare Oscar/Certification