Provider Demographics
NPI:1972748705
Name:UMDNJ
Entity type:Organization
Organization Name:UMDNJ
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:RESIDENCY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAUTONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-972-6015
Mailing Address - Street 1:310 VARICK ST
Mailing Address - Street 2:GF
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-3404
Mailing Address - Country:US
Mailing Address - Phone:201-401-8003
Mailing Address - Fax:
Practice Address - Street 1:310 VARICK ST
Practice Address - Street 2:GF
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-3404
Practice Address - Country:US
Practice Address - Phone:201-401-8003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital