Provider Demographics
NPI:1902901333
Name:CLARA MAASS MEDICAL CENTER
Entity Type:Organization
Organization Name:CLARA MAASS MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:CLYNE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:973-450-2002
Mailing Address - Street 1:1 CLARA MAASS DR
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07109-3550
Mailing Address - Country:US
Mailing Address - Phone:973-450-2000
Mailing Address - Fax:973-844-4924
Practice Address - Street 1:1 CLARA MAASS DR
Practice Address - Street 2:REIMBURSEMENT DEPARTMENT
Practice Address - City:BELLEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07109-3550
Practice Address - Country:US
Practice Address - Phone:973-450-2105
Practice Address - Fax:973-844-4924
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RWJ BARNABAS HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-13
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ10701282N00000X
NJ282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4135504Medicaid
NJ4135504Medicaid