Organization
ST. MARY'S HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT BODNAR (DIRECTOR OR PATIENT ACCOUNTS)
(973) 365-3012
Entity
Organization
Contact information
Practice address
530 MAIN AVE, PASSAIC, NJ 07055-5700
(973) 470-3165
Mailing address
350 BOULEVARD, PASSAIC, NJ 07055-2840
(973) 365-3012
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8801011
—
NJ
Enumeration date
04/03/2007
Last updated
08/22/2020
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