Organization Name: | NNA-SAINT BARNABAS, L.L.C. |
NPI Number: | 1679677447 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK R FAWCETT (TREASURER) |
Mailing Address: | 131 S 31st St Kenilworth |
State: | NJ US |
Postal Code: | 070331331 |
Phone Number: | 9082062275 |
Fax Number: | 9082062285 |
NPI Enumeration Date: | 09/12/2006 |
NPI Last Update Date: | 10/16/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
Taxonomy Definition: |