Holy Name Hospital Regional Dialysis Center

Organization Active NPI End-Stage Renal Disease (ESRD) Treatment Clinic/Center · Teaneck, NJ

NPI 1043389349 · NPPES record last updated Jul 13, 2007

Key facts

NPI
1043389349
Entity type
Organization (NPI type 2)
Primary specialty
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
Legal business name
HOLY NAME HOSPITAL REGIONAL DIALYSIS CENTER
Practice address
718 Teaneck Rd
Teaneck, NJ 07666-4245
Phone
(201) 833-3000
Fax
(201) 833-4486
NPI assigned
Nov 8, 2006
Organization subpart
No

Authorized official

Name
Ms. Suzanne Juliano
Title
Director, Dialysis Center
Phone
(201) 833-3000

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Facilities connected through Provider of Services related, parent or unit certification numbers.

Affiliated clinicians 778

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 778

Medicare Care Compare: Hospital

Listed as
Holy Name Medical Center CCN 310008
Overall star rating
★★★★★ 5 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ

Hospital certification: CCN 310008

Legal name
HOLY NAME MEDICAL CENTER INC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Feb 3, 2023
Beds
372
Ownership / control type
Private (not for profit)
Organization structure
Corporation · Non-profit
Incorporated
Jun 24, 1958 in NJ
Enrollment address
718 Teaneck Rd
Teaneck, NJ 76664245
Hospital Psychiatric Unit
Hospital subgroups
Acute care

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Santo Gencarelli
Individual
Contracted Managing Employee
Ad;
Aug 26, 2025
Corporate Officer Aug 26, 2025
W-2 Managing Employee
Ad;
Aug 26, 2025
Michael Maron
Individual
Corporate Director
Director
Aug 1, 2010

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20110126000050 NJ Part a Provider - Hospital 3971665183 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Englewood, NJ; Hackensack, NJ; Oradell, NJ; Teaneck, NJ; Union City, NJ

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X Yes

Addresses

Primary practice location

718 Teaneck Rd
Teaneck, NJ 07666-4245

Mailing address

718 Teaneck Rd
Teaneck, NJ 07666-4245
Phone (201) 833-3000

Other identifiers

IdentifierTypeStateIssuer
4135407MedicaidNJ

Other providers in Teaneck, NJ

All providers in Teaneck, NJ · End-Stage Renal Disease (ESRD) Treatment Clinic/Center in New Jersey

Sources for this page

Verify at the official NPI Registry.