Provider Demographics
NPI:1396886297
Name:CHILDREN'S SPECIALIZED HOSPITAL
Entity type:Organization
Organization Name:CHILDREN'S SPECIALIZED HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP & SITE FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:GERIANN
Authorized Official - Middle Name:
Authorized Official - Last Name:SWENARTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-501-7052
Mailing Address - Street 1:150 NEW PROVIDENCE RD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAINSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07092-2590
Mailing Address - Country:US
Mailing Address - Phone:888-244-5373
Mailing Address - Fax:732-258-7213
Practice Address - Street 1:200 SOMERSET ST
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1942
Practice Address - Country:US
Practice Address - Phone:732-258-7000
Practice Address - Fax:908-301-5456
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RWJ BARNABAS HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-12
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22249208000000X, 261QR0401X, 283XC2000X
NJ204140804261QM0855X
NJ20703261QP2300X
NJ2248283XC2000X
NJ28RS004173003336I0012X
NJ28RS006752003336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes283XC2000XHospitalsRehabilitation HospitalChildren
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental HealthGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No3336I0012XSuppliersPharmacyInstitutional PharmacyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0816612Medicaid
NJ3684504Medicaid
NJ4439902Medicaid