Provider Demographics
NPI:1568669380
Name:IJKG OPCO LLC
Entity Type:Organization
Organization Name:IJKG OPCO LLC
Other - Org Name:BAYONNE HOSPITAL CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-858-7111
Mailing Address - Street 1:29TH STREET AT AVENUE E
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002
Mailing Address - Country:US
Mailing Address - Phone:201-858-5000
Mailing Address - Fax:201-858-7333
Practice Address - Street 1:29TH STREET AT AVENUE E
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002
Practice Address - Country:US
Practice Address - Phone:201-858-5000
Practice Address - Fax:201-858-7333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273R00000XHospital UnitsPsychiatric Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4136705Medicaid
NJ31S025Medicare Oscar/Certification