Provider Demographics
NPI:1770631749
Name:SAINT CLARE'S HOSPITAL
Entity Type:Organization
Organization Name:SAINT CLARE'S HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TEAM LEADER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:ELKO
Authorized Official - Suffix:
Authorized Official - Credentials:LRC
Authorized Official - Phone:973-401-2172
Mailing Address - Street 1:149 EMMANS RD
Mailing Address - Street 2:
Mailing Address - City:FLANDERS
Mailing Address - State:NJ
Mailing Address - Zip Code:07836-9041
Mailing Address - Country:US
Mailing Address - Phone:973-252-1834
Mailing Address - Fax:
Practice Address - Street 1:100 E HANOVER AVE
Practice Address - Street 2:
Practice Address - City:CEDAR KNOLLS
Practice Address - State:NJ
Practice Address - Zip Code:07927-2020
Practice Address - Country:US
Practice Address - Phone:973-401-2172
Practice Address - Fax:973-401-2183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37RC00101800251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health