Provider Demographics
NPI:1609847870
Name:ST JOSEPH'S HOSPITAL AND MEDICAL CENTER
Entity Type:Organization
Organization Name:ST JOSEPH'S HOSPITAL AND MEDICAL CENTER
Other - Org Name:ST JOSEPH'S WAYNE MEDICAL CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR, FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:CAULFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-754-2016
Mailing Address - Street 1:703 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07503-2621
Mailing Address - Country:US
Mailing Address - Phone:973-754-2000
Mailing Address - Fax:973-754-2149
Practice Address - Street 1:224 HAMBURG TURNPIKE
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2111
Practice Address - Country:US
Practice Address - Phone:973-956-3500
Practice Address - Fax:973-389-4044
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST JOSEPH'S HOSPITAL AND MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-01-27
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ11603273Y00000X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit
No282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4141407Medicaid
NJ4136403Medicaid
NJ4141407Medicaid
31T019Medicare PIN