Provider Demographics
NPI:1427333475
Name:HACKENSACK UNIVERSITY MEDICAL CENER
Entity type:Organization
Organization Name:HACKENSACK UNIVERSITY MEDICAL CENER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:SOON JA
Authorized Official - Middle Name:
Authorized Official - Last Name:OH
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:201-996-2000
Mailing Address - Street 1:42 LAKEWOOD TERRACE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003
Mailing Address - Country:US
Mailing Address - Phone:973-680-8733
Mailing Address - Fax:
Practice Address - Street 1:42 LAKEWOOD TER
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-3722
Practice Address - Country:US
Practice Address - Phone:973-680-8733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-20
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO09947700261QX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0200XAmbulatory Health Care FacilitiesClinic/CenterOncology