Provider Demographics
NPI:1730144213
Name:NEWARK BETH ISRAEL MEDICAL CENTER
Entity Type:Organization
Organization Name:NEWARK BETH ISRAEL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PATHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:WEIWEI
Authorized Official - Middle Name:
Authorized Official - Last Name:NIU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-926-7580
Mailing Address - Street 1:201 LYONS AVE
Mailing Address - Street 2:DEPARTMENT OF LABORATOY MEDICINE AND PATHOLOGY
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07112-2027
Mailing Address - Country:US
Mailing Address - Phone:973-926-7580
Mailing Address - Fax:973-705-8301
Practice Address - Street 1:201 LYONS AVE
Practice Address - Street 2:DEPARTMENT OF LABORATOY MEDICINE AND PATHOLOGY
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2027
Practice Address - Country:US
Practice Address - Phone:973-926-7580
Practice Address - Fax:973-705-8301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07938700291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2K1019Medicare UPIN
NJ01000764100Medicare UPIN
NJDENIED SPECMedicare UPIN
NJ5098818Medicare UPIN
NJ0073351Medicare UPIN
NJNP40562Medicare UPIN
NJ60016690Medicare UPIN
NJ093744NTTMedicare UPIN
NJNP294134Medicare UPIN