Albert Einstein Medical Center
Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Woodbury, NJ
NPI 1144619263 · NPPES record last updated Jan 13, 2015
Key facts
- NPI
- 1144619263
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
- License
- TB1078 (NJ)
- Legal business name
- ALBERT EINSTEIN MEDICAL CENTER
- Practice address
- 135 S Broad St
Woodbury, NJ 08096-2441 - Phone
- (856) 853-9900
- NPI assigned
- Jan 13, 2015
- Organization subpart
- Yes
- Parent organization (as reported)
- ALBERT EINSTEIN MEDICAL CENTER
Authorized official
- Name
- Mr. Walter G Wyatt
- Title
- Assoc VP-Finance
- Phone
- (215) 254-3254
Corporate family (same tax ID) 11
National Provider Directory
- Tax ID family
- Albert Einstein Medical Center
- Part of
- Albert Einstein Medical Center
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | TB1078 | NJ | Yes |
Addresses
Primary practice location
135 S Broad St
Woodbury, NJ 08096-2441
Mailing address
5501 Old York Rd
Philadelphia, PA 19141-3018
Phone (215) 456-9000
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8079102 | Medicaid | NJ | |
| 8756601 | Medicaid | NJ |
Other names
- MOSS REHAB - DRUCKER BRAIN INJURY CENTER (WOODBURY, NJ)
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All providers in Woodbury, NJ · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 13, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.