Organization
MONTCLAIR HOSPITAL LLC
Active
Organization
MONTCLAIR HOSPITAL LLC
Active
Other names
ESRD Facility
Organization subpart
No
Provider details
NPI number
Authorized official
JOE JOHNSON (VICE PRESIDENT)
(866) 465-9222
Entity
Organization
Contact information
Practice address
1 BAY AVE, MONTCLAIR, NJ 07042-4837
(973) 429-6451
Mailing address
1 BAY AVE, MONTCLAIR, NJ 07042-4837
(973) 429-6000
(973) 429-6209
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0139564
—
NJ
Enumeration date
11/05/2008
Last updated
06/11/2013
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