Provider Demographics
NPI:1861527673
Name:JERSEY SHORE UNIVERSITY HOSPITAL
Entity type:Organization
Organization Name:JERSEY SHORE UNIVERSITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-869-2788
Mailing Address - Street 1:103 10TH AVE APT 5
Mailing Address - Street 2:
Mailing Address - City:BELMAR
Mailing Address - State:NJ
Mailing Address - Zip Code:07719-2362
Mailing Address - Country:US
Mailing Address - Phone:732-859-9639
Mailing Address - Fax:
Practice Address - Street 1:402 STATE ROUTE 35 N
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4604
Practice Address - Country:US
Practice Address - Phone:732-869-2788
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital