Provider Demographics
NPI:1548489701
Name:RICHMOND UNIVERSITY MEDICAL CENTER
Entity type:Organization
Organization Name:RICHMOND UNIVERSITY MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:L
Authorized Official - Last Name:ARSURA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-818-2429
Mailing Address - Street 1:222 PROSPECT AVE
Mailing Address - Street 2:FLOOR 2
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-4722
Mailing Address - Country:US
Mailing Address - Phone:646-251-5722
Mailing Address - Fax:718-818-3225
Practice Address - Street 1:355 BARD AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10310-1664
Practice Address - Country:US
Practice Address - Phone:718-818-2430
Practice Address - Fax:718-818-3225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY241341-1275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit