Basic Information
| Provider Information | |||||||||
| NPI: | 1790297455 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HMH HOSPITALS CORPORATION | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | RARITAN BAY MEDICAL CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 TORMEE DR FL 2 | ||||||||
| Address2: | |||||||||
| City: | TINTON FALLS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077127502 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7328977107 | ||||||||
| FaxNumber: | 7328977227 | ||||||||
| Practice Location | |||||||||
| Address1: | 530 NEW BRUNSWICK AVE | ||||||||
| Address2: | |||||||||
| City: | PERTH AMBOY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 088613654 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7324423700 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2017 | ||||||||
| LastUpdateDate: | 11/02/2017 | ||||||||
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| AuthorizedOfficialLastName: | SAWCZUK | ||||||||
| AuthorizedOfficialFirstName: | IHOR | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5519962002 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
No ID Information.