Provider Demographics
NPI:1750107298
Name:RUTGERS, THE STATE UNIVERSITY
Entity type:Organization
Organization Name:RUTGERS, THE STATE UNIVERSITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE VICE CHANCELLOR, HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:NOA'A
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIMONI
Authorized Official - Suffix:
Authorized Official - Credentials:MD MPH
Authorized Official - Phone:848-932-7402
Mailing Address - Street 1:11 BISHOP PL
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-1178
Mailing Address - Country:US
Mailing Address - Phone:848-932-7402
Mailing Address - Fax:
Practice Address - Street 1:11 BISHOP PL
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1178
Practice Address - Country:US
Practice Address - Phone:848-932-7402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RUTGERS, THE STATE UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty