Provider Demographics
NPI:1942757125
Name:SAINT JOSEPH REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:SAINT JOSEPH REGIONAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:CHANDRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDRA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-754-2000
Mailing Address - Street 1:192 COMPTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-0300
Mailing Address - Country:US
Mailing Address - Phone:516-667-9476
Mailing Address - Fax:
Practice Address - Street 1:703 MAIN STREET
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07503-3700
Practice Address - Country:US
Practice Address - Phone:973-754-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital