Organization
JEWISH RENAISSANCE MEDICAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ROBERTS (CEO)
(732) 376-6601
Entity
Organization
Contact information
Practice address
90 PARKER ST, NEWARK, NJ 07104-1028
(973) 497-5773
Mailing address
PO BOX 1220, PERTH AMBOY, NJ 08862-1220
(732) 376-6601
(732) 324-5765
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
23973
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0097811
—
NJ
05
—
0115045
—
NJ
05
—
0751103
—
NJ
05
—
8462500
—
NJ
05
—
8932603
—
NJ
Enumeration date
05/04/2007
Last updated
10/20/2009
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