Provider Demographics
NPI:1982757621
Name:NEWARK BETH ISRAEL MED CENTER
Entity Type:Organization
Organization Name:NEWARK BETH ISRAEL MED CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALLA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUDELZAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-668-3069
Mailing Address - Street 1:26 LYNNWOOD RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08820-2707
Mailing Address - Country:US
Mailing Address - Phone:732-662-9028
Mailing Address - Fax:
Practice Address - Street 1:PARK AVE & RANDOLPH RD
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07061
Practice Address - Country:US
Practice Address - Phone:908-668-2122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05848600282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital