Organization
RARITAN BAY MEDICAL CENTER PROFESSIONAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM SHANAHAN (CEO)
(732) 293-2314
Entity
Organization
Contact information
Practice address
1 HOSPITAL PLZ, OLD BRIDGE, NJ 08857-3012
(732) 324-5348
(732) 324-4811
Mailing address
PO BOX 48270, NEWARK, NJ 07101-4800
(201) 818-9118
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
25MA02710200
NJ
174400000X
Specialist
Primary
25MA03121400
NJ
174400000X
Specialist
25MA03479600
NJ
174400000X
Specialist
25MA04327900
NJ
174400000X
Specialist
25MA05255000
NJ
174400000X
Specialist
25MA05696500
NJ
174400000X
Specialist
25MA05746900
NJ
174400000X
Specialist
25MA05873200
NJ
Other
Enumeration date
09/25/2006
Last updated
08/22/2020
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