Provider Demographics
NPI:1861548539
Name:SAINT BARNABAS OUTPATIENT CENTERS
Entity type:Organization
Organization Name:SAINT BARNABAS OUTPATIENT CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:GIBNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-322-7286
Mailing Address - Street 1:1050 GALLOPING HILL RD
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-7983
Mailing Address - Country:US
Mailing Address - Phone:908-206-2231
Mailing Address - Fax:908-206-2237
Practice Address - Street 1:200 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5817
Practice Address - Country:US
Practice Address - Phone:973-322-7281
Practice Address - Fax:973-322-7283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ70786261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ305438Medicare Oscar/Certification
NJ034350Medicare ID - Type UnspecifiedSBOC(SPORTS INSTITUTE)
NJ097673Medicare ID - Type UnspecifiedSBOC(IMAGING, BREAST)
NJ034222Medicare ID - Type UnspecifiedSBOC(SIEGLER CENTER)
NJ828758Medicare ID - Type UnspecifiedSBOC (PAIN INSTITUTE)
NJ099678Medicare ID - Type UnspecifiedSBOC(MULTIPLE SCLEROSIS)
NJ316700Medicare ID - Type UnspecifiedSBOC (OUTPATIENT REHAB)
NJ001976Medicare ID - Type UnspecifiedSBOC(OSTEOPOROSIS CENTER)
NJ118521Medicare Oscar/Certification