Provider Demographics
NPI:1386780807
Name:NEWARK EXTENDED CARE FACILITY INC
Entity type:Organization
Organization Name:NEWARK EXTENDED CARE FACILITY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MORTON
Authorized Official - Middle Name:
Authorized Official - Last Name:PANETH
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:973-483-6800
Mailing Address - Street 1:65 JAY STREET
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103
Mailing Address - Country:US
Mailing Address - Phone:973-488-6800
Mailing Address - Fax:973-483-1841
Practice Address - Street 1:65 JAY STREET
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103
Practice Address - Country:US
Practice Address - Phone:973-488-6800
Practice Address - Fax:973-483-1841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332800000XSuppliersIndian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
Not Answered332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
0971360001OtherM CARE PART B
315236Medicare ID - Type Unspecified
NJ4476204Medicare ID - Type Unspecified