Basic Information
| Provider Information | |||||||||
| NPI: | 1811597701 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HMH HOSPITALS CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | HMH HOSPITALS CORPORATION, ATTN: BEHAVIORAL HEALTH CRED | ||||||||
| Address2: | 1200 JUMPING BROOK ROAD, BLDG 5, STE 201 | ||||||||
| City: | NEPTUNE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07753 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7326434372 | ||||||||
| FaxNumber: | 7326434376 | ||||||||
| Practice Location | |||||||||
| Address1: | 1945 ROUTE 33 | ||||||||
| Address2: | |||||||||
| City: | NEPTUNE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07753 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7326434372 | ||||||||
| FaxNumber: | 7326434376 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2020 | ||||||||
| LastUpdateDate: | 10/29/2020 | ||||||||
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| AuthorizedOfficialLastName: | KOCZAN | ||||||||
| AuthorizedOfficialFirstName: | MARILYN | ||||||||
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| AuthorizedOfficialTitleorPosition: | SENIOR VP REVENUE CYCLE OPERATIONS | ||||||||
| AuthorizedOfficialTelephone: | 7328977800 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | HMH HOSPITALS CORPORATION | ||||||||
| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| NPICertificationDate: | 10/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
No ID Information.