Provider Demographics
NPI:1912254855
Name:ST. MARYS HOSPITAL- SETON CENTER
Entity Type:Organization
Organization Name:ST. MARYS HOSPITAL- SETON CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN BILLING,PORTAL COORDINATO
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-365-4830
Mailing Address - Street 1:530 MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-5700
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:530 MAIN AVE
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-5700
Practice Address - Country:US
Practice Address - Phone:973-470-3056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. MARY'S HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-09
Last Update Date:2012-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05723500282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural