Provider Demographics
NPI:1396712956
Name:NEWARK BETH ISRAEL HOSPITAL
Entity type:Organization
Organization Name:NEWARK BETH ISRAEL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CARDIOTHORACIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:R
Authorized Official - Last Name:SAUNDERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-926-7749
Mailing Address - Street 1:31 PRIMROSE LN
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-3441
Mailing Address - Country:US
Mailing Address - Phone:973-926-7749
Mailing Address - Fax:973-923-4683
Practice Address - Street 1:201 LYONS AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2027
Practice Address - Country:US
Practice Address - Phone:973-926-7749
Practice Address - Fax:973-923-4683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06765300281P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes281P00000XHospitalsChronic Disease Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7663404Medicaid
NJA37131Medicare UPIN
NJ020016PEVMedicare ID - Type Unspecified