NPIMap

Organization Active NPI

Saint Michaels Medical Center Inc.

Doing business as The Peter Ho Memorial Clinic

  • Primary Care Clinic/Center
  • Newark, NJ
National Provider Identifier
1124475991
Registry record updated May 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
SAINT MICHAELS MEDICAL CENTER INC.
Doing business as
The Peter Ho Memorial Clinic
Practice address
111 Central Ave
Newark, NJ 07102-1909
Phone
(973) 877-5649
Fax
(973) 877-2824
NPI assigned
May 20, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
David A Ricci
Title
Chief Executive Officer
Phone
(732) 458-7955

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

111 Central Ave
Newark, NJ 07102-1909

Mailing address

111 Central Ave
Newark, NJ 07102-1909
Phone (973) 877-5649

Other names 1

  • The Peter Ho Memorial Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Saint Michaels Medical Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463702400000",
    "number": "1124475991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CENTRAL AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021909",
            "telephone_number": "973-877-5649",
            "fax_number": "973-877-2824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 CENTRAL AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071021909",
            "telephone_number": "973-877-5649",
            "fax_number": "973-877-2824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT MICHAELS MEDICAL CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-20",
        "last_updated": "2016-05-20",
        "status": "A",
        "authorized_official_last_name": "RICCI",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "732-458-7955"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Peter Ho Memorial Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.