Provider Demographics
NPI:1639210180
Name:CHILDRENS SPECIALIZED HOSPITAL
Entity Type:Organization
Organization Name:CHILDRENS SPECIALIZED HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, FINANCE & CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:DOBOSH
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:908-301-5455
Mailing Address - Street 1:150 NEW PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAINSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07092-2590
Mailing Address - Country:US
Mailing Address - Phone:908-233-3720
Mailing Address - Fax:908-301-5456
Practice Address - Street 1:150 NEW PROVIDENCE RD
Practice Address - Street 2:
Practice Address - City:MOUNTAINSIDE
Practice Address - State:NJ
Practice Address - Zip Code:07092-2590
Practice Address - Country:US
Practice Address - Phone:908-233-3720
Practice Address - Fax:908-301-5456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22249332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ01000192906OtherAMERIHEALTH
NJ1025388OtherHORIZON NJ HEALTH
NJ313300OtherHORIZON BCBS
NJ0778139002OtherAMERIHEALTH
NJ10832OtherUNIVERSITY HEALTH PLANS
NJ01000192900OtherAMERIHEALTH
NJIL5516OtherHEALTHNET
NJ99853OtherAMERIGROUP
NJHO1318OtherOXFORD HEALTH PLANS
NJ01000192903OtherAMERIHEALTH
NJ1621OtherEMPIRE
NJ=========OtherCONSUMER HEALTH NETWORK
NJ0778139002OtherAMERIHEALTH
NJ=========-011OtherCIGNA HEALTHCARE
NJ01000192903OtherAMERIHEALTH
NJ99853OtherAMERIGROUP
NJ=========OtherMAGNACARE
NJHO1318OtherOXFORD HEALTH PLANS
NJIL5516OtherHEALTHNET
NJ=========OtherMAGNACARE