JEWISH RENAISSANCE MEDICAL CENTER INC. NPI 1225240971

NPI Information

NPI: 1225240971
Provider Name: JEWISH RENAISSANCE MEDICAL CENTER, INC.
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
226 DAYTON ST
NEWARK, NJ
ZIP 07114
Phone: (973) 733-8781
Get Directions

JEWISH RENAISSANCE MEDICAL CENTER, INC. is a federally qualified health center (fqhc) clinic center in Newark, NJ. JEWISH RENAISSANCE MEDICAL CENTER, INC. NPI is 1225240971. The provider is registered as an organization entity type.

The provider's business location address is:

226 DAYTON ST
NEWARK, NJ
ZIP 07114-159
Phone: (973) 733-8781

The provider's authorized official is Mark Roberts .
The authorized official title is Ceo and has the following contact phone number (732) 376-6601.

The enumeration date for this NPI number is 5/4/2007 and was last updated on 10/20/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	23981	NEW JERSEY	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	0751103	MEDICAID	NEW JERSEY
2	104936Q3J	MEDICARE PIN	NEW JERSEY
3	712952Q3J	MEDICARE PIN	NEW JERSEY
4	063701	MEDICARE PIN	NEW JERSEY
5	0115045	MEDICAID	NEW JERSEY
6	8932603	MEDICAID	NEW JERSEY
7	100321Q3J	MEDICARE PIN	NEW JERSEY
8	047027Q3J	MEDICARE PIN	NEW JERSEY
9	0097845	MEDICAID	NEW JERSEY
10	8462500	MEDICAID	NEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »