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Organization
ST. JOSEPH'S REGIONAL MEDICAL CENTER
Active
Organization
ST. JOSEPH'S REGIONAL MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIANNE LANNO (MANAGED CARE PHYSICIAN CREDENTIALIN)
(979) 754-2052
Entity
Organization
Contact information
Practice address
400 RIVERFRONT BLVD, 119, ELMWOOD PARK, NJ 07407-3600
(787) 679-4700
Mailing address
703 MAIN ST, PATERSON, NJ 07503-2621
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
39
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
072314
DOC NUMBER
—
Enumeration date
07/23/2014
Last updated
07/23/2014
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