Provider Demographics
NPI:1811107493
Name:NEW JERSEY MEDICAL SCHOOL-GLOBAL TUBERCULOSIS INSTITUTE
Entity type:Organization
Organization Name:NEW JERSEY MEDICAL SCHOOL-GLOBAL TUBERCULOSIS INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:B
Authorized Official - Last Name:REICHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-972-9006
Mailing Address - Street 1:225 WARREN ST
Mailing Address - Street 2:1ST FLOOR, EAST WING
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103-3535
Mailing Address - Country:US
Mailing Address - Phone:973-972-6232
Mailing Address - Fax:973-972-3832
Practice Address - Street 1:225 WARREN ST
Practice Address - Street 2:1ST FLOOR, EAST WING
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-3535
Practice Address - Country:US
Practice Address - Phone:973-972-6232
Practice Address - Fax:973-972-3832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN04408200261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty