Provider Demographics
NPI:1528320637
Name:UNIVERSITY OF MEDICINE AND DENTISTRY - NEW JERSEY
Entity type:Organization
Organization Name:UNIVERSITY OF MEDICINE AND DENTISTRY - NEW JERSEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GME PROGRAM COORDINATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARI
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-972-5209
Mailing Address - Street 1:436 HERKIMER ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-1032
Mailing Address - Country:US
Mailing Address - Phone:917-971-3884
Mailing Address - Fax:
Practice Address - Street 1:185 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103-2757
Practice Address - Country:US
Practice Address - Phone:917-971-3884
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-13
Last Update Date:2012-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty