Basic Information
| Provider Information | |||||||||
| NPI: | 1861527673 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JERSEY SHORE UNIVERSITY HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 103 10TH AVE APT 5 | ||||||||
| Address2: | |||||||||
| City: | BELMAR | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077192362 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7328599639 | ||||||||
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| Practice Location | |||||||||
| Address1: | 402 STATE ROUTE 35 N | ||||||||
| Address2: | |||||||||
| City: | NEPTUNE | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077534604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7328692788 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/22/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | SILVA | ||||||||
| AuthorizedOfficialFirstName: | PETER | ||||||||
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| AuthorizedOfficialTitleorPosition: | SUPERVISOR | ||||||||
| AuthorizedOfficialTelephone: | 7328692788 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | LCSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 284300000X | Y | Hospitals | Special Hospital |
No ID Information.