Provider Demographics
NPI:1487903456
Name:ENGLEWOOD HOSPITAL AND MEDICAL CENTER
Entity type:Organization
Organization Name:ENGLEWOOD HOSPITAL AND MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAMMASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:120-189-4300
Mailing Address - Street 1:260 ENGLE ST APT 4K
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-2423
Mailing Address - Country:US
Mailing Address - Phone:201-417-9613
Mailing Address - Fax:
Practice Address - Street 1:350 ENGLE ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-1808
Practice Address - Country:US
Practice Address - Phone:201-894-3000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MOUNT SINAI SCHOOL OF MEDICINE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-05
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital