Organization Name: | ST. MARY'S HOSPITAL |
NPI Number: | 1104947654 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT BODNAR (DIRECTOR OR PATIENT ACCOUNTS) |
Mailing Address: | 530 Main Ave Passaic |
State: | NJ US |
Postal Code: | 070555700 |
Phone Number: | 9734703165 |
Fax Number: | |
NPI Enumeration Date: | 04/03/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0850X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Adult Mental Health |
Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |