Raritan Bay Medical Center Professional Services

Primary specialty

SpecialistTaxonomy code 174400000X

License

25MA07867800 Issued in NJ

Legal business name

RARITAN BAY MEDICAL CENTER PROFESSIONAL SERVICES

Practice address

500 Lawrie St
Perth Amboy, NJ 08861-3046

Phone

(732) 324-5231

Fax

(732) 324-5233

NPI assigned

Oct 2, 2006

Last updated

Aug 22, 2020By 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

Tom Shanahan

Title

Ceo

Phone

(732) 293-2314

Specialties & licenses 2

Addresses

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.

• Jennifer Jao, MD

  • Pediatric Infectious Diseases Physician
  • Chicago, IL
  • NPI 1295779908

  Specialist

  NPD (past)

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306939434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 48277",
            "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": "500 LAWRIE ST",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613046",
            "telephone_number": "732-324-5231",
            "fax_number": "732-324-5233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RARITAN BAY MEDICAL CENTER PROFESSIONAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "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": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA07854400",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NJ",
            "license": "25MA07867800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raritan Bay Medical Center
• Raritan Bay Medical Center
• Raritan Bay Medical Center
• Raritan Bay Medical Center Professional Services
• Raritan Bay Medical Center Professional Services
• Raritan Bay Oral & Maxillofacial Surgery PA
• Raritan Bay Pharmacy Inc
• Raritan Bay Pharmacy Inc (Raritan Bay Pharmacy and Surgical)
• Raritan Bay Physicians Group PC
• Raritan Management Corporation

• Specialist in Perth Amboy, NJ
• Providers in Perth Amboy, NJ by specialty
• Specialist in New Jersey

• 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.