Provider Demographics
NPI:1801274634
Name:ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER
Entity type:Organization
Organization Name:ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-754-2016
Mailing Address - Street 1:703 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07503-2621
Mailing Address - Country:US
Mailing Address - Phone:973-754-2000
Mailing Address - Fax:973-754-2149
Practice Address - Street 1:320 SULLIVAN WAY
Practice Address - Street 2:COTTAGE 1
Practice Address - City:EWING
Practice Address - State:NJ
Practice Address - Zip Code:08628-3405
Practice Address - Country:US
Practice Address - Phone:609-643-5805
Practice Address - Fax:609-643-5507
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. JOSEPH'S HOSPITAL AND MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-05-13
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0393746Medicaid