Provider Demographics
NPI:1386710283
Name:CHRIST HOSPITAL
Entity type:Organization
Organization Name:CHRIST HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COORDINATOR, TOBACCO INDEPENDENCE
Authorized Official - Prefix:MRS
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MONROY-SIDDALL
Authorized Official - Suffix:
Authorized Official - Credentials:LSW
Authorized Official - Phone:866-904-8281
Mailing Address - Street 1:1212 WHEATSHEAF RD
Mailing Address - Street 2:
Mailing Address - City:ROSELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07203-2518
Mailing Address - Country:US
Mailing Address - Phone:908-620-0925
Mailing Address - Fax:201-418-7017
Practice Address - Street 1:179 PALISADE AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-1103
Practice Address - Country:US
Practice Address - Phone:866-904-8281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05239300104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty