Basic Information
| Provider Information | |||||||||
| NPI: | 1417214883 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | UMDNJ-RWJMS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 125 PATERSON ST | ||||||||
| Address2: | |||||||||
| City: | NEW BRUNSWICK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 089011962 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322356632 | ||||||||
| FaxNumber: | 7322357054 | ||||||||
| Practice Location | |||||||||
| Address1: | 125 PATERSON ST | ||||||||
| Address2: | |||||||||
| City: | NEW BRUNSWICK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 089011962 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7322356600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2012 | ||||||||
| LastUpdateDate: | 04/23/2012 | ||||||||
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| AuthorizedOfficialLastName: | BACHMAN | ||||||||
| AuthorizedOfficialFirstName: | GLORIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | INTERIM DEPARTMENT CHAIR OB GYN | ||||||||
| AuthorizedOfficialTelephone: | 7322357628 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 25MA08995800 | NJ | N | Hospitals | General Acute Care Hospital | 261QH0100X | 25MA08995800 | NJ | Y | Ambulatory Health Care Facilities | Clinic/Center | Health Service |
No ID Information.