Provider Demographics
NPI:1992096374
Name:HACKENSACK UNIVERSITY MEDICAL CENTER
Entity type:Organization
Organization Name:HACKENSACK UNIVERSITY MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT/OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:NAVEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MANSUKHANI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:201-996-4092
Mailing Address - Street 1:92 2ND ST
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-2105
Mailing Address - Country:US
Mailing Address - Phone:201-996-5427
Mailing Address - Fax:551-996-0768
Practice Address - Street 1:92 2ND ST
Practice Address - Street 2:1ST FLOOR
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2105
Practice Address - Country:US
Practice Address - Phone:201-996-5427
Practice Address - Fax:551-996-0768
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HACKENSACK UNIVERSITY MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy