NPIMap

Organization Active NPI

Raritan Bay Medical Center Professional Services

  • Specialist
  • Perth Amboy, NJ
National Provider Identifier
1134201635
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
25MA05881000 Issued in NJ
Legal business name
RARITAN BAY MEDICAL CENTER PROFESSIONAL SERVICES
Practice address
516 Lawrie St
Perth Amboy, NJ 08861-3046
Phone
(732) 324-3360
Fax
(732) 324-3327
NPI assigned
Oct 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Tom Shanahan
Title
Ceo
Phone
(732) 293-2314

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X 25MA05881000 NJ Primary

Addresses

Primary practice location

516 Lawrie St
Perth Amboy, NJ 08861-3046

Mailing address

PO Box 48270
Newark, NJ 07101-4800
Phone (201) 818-9118

National Provider Directory

National Provider Directory
Tax ID family
Raritan Bay Medical Center Professional Services7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1134201635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 48270",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071014800",
            "telephone_number": "201-818-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 LAWRIE ST",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613046",
            "telephone_number": "732-324-3360",
            "fax_number": "732-324-3327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RARITAN BAY MEDICAL CENTER PROFESSIONAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHANAHAN",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "732-293-2314"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA05881000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perth Amboy, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.