Provider Demographics
NPI:1356429781
Name:SAINT BARNABAS MEDICAL CENTER
Entity type:Organization
Organization Name:SAINT BARNABAS MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:SHAPIRO
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:973-322-7620
Mailing Address - Street 1:200 SOUTH ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07078
Mailing Address - Country:US
Mailing Address - Phone:973-322-7620
Mailing Address - Fax:973-322-7504
Practice Address - Street 1:200 S ORANGE AVE
Practice Address - Street 2:PEDIATRIC SPECIALTY CENTER
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5817
Practice Address - Country:US
Practice Address - Phone:973-322-7620
Practice Address - Fax:973-322-7504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-02
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00434100261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service