Provider Demographics
NPI:1881909323
Name:JERSEY SHORE MEDICAL CENTER
Entity type:Organization
Organization Name:JERSEY SHORE MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-776-4865
Mailing Address - Street 1:1945,CORLIES AVE
Mailing Address - Street 2:ROUTE 33
Mailing Address - City:NEPTUNE CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07754
Mailing Address - Country:US
Mailing Address - Phone:732-325-7823
Mailing Address - Fax:
Practice Address - Street 1:1945 CORLIES AVE
Practice Address - Street 2:ROUTE 33
Practice Address - City:NEPTUNE CITY
Practice Address - State:NJ
Practice Address - Zip Code:07753-4859
Practice Address - Country:US
Practice Address - Phone:732-776-4267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-09
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08794900282NC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC2000XHospitalsGeneral Acute Care HospitalChildren