Montclair Hospital, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MONTCLAIR HOSPITAL, LLC

Doing business as

Hackensack UMC Mountainside

Practice address

1 Bay Ave
Montclair, NJ 07042-4837

Phone

(973) 429-6000

NPI assigned

Dec 3, 2021

Last updated

Dec 3, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tim Obrien

Title

Ceo

Phone

(973) 429-6314

Specialties & licenses 1

Addresses

Other names 1

• Hackensack UMC Mountainside Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Julia Ilyin, PHARMD

  • Pharmacist
  • Marlboro, NJ
  • NPI 1457009110
  NPD

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

{
    "created_epoch": "1638489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638489600000",
    "number": "1245998541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BAY AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424837",
            "telephone_number": "973-429-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BAY AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070424837",
            "telephone_number": "973-429-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTCLAIR HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-03",
        "last_updated": "2021-12-03",
        "certification_date": "2021-11-22",
        "status": "A",
        "authorized_official_last_name": "OBRIEN",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "973-429-6314"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hackensack UMC Mountainside",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Montclair Hospital LLC (Outpatient Behavioral Health Department)
• Montclair Hospital LLC (Tcu)
• Montclair Hospital LLC (Internal Medicine Department)
• Montclair Hospital LLC (Psych Unit)
• Montclair Hospital LLC (HackensackUMC Mountainside)
• Montclair Memory Clinic LLC
• Montclair Pathology Associates, PA
• Montclair Pediatrics
• Montclair Performance Health and Chiropractic Inc
• Montclair Physical Therapy Associates PA

• Community/Retail Pharmacy in Montclair, NJ
• Providers in Montclair, NJ by specialty
• Community/Retail Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.