Organization
JEWISH RENAISSANCE MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACK O'LEARY (CEO)
(732) 376-9333
Entity
Organization
Contact information
Practice address
275 HOBART ST, PERTH AMBOY, NJ 08861-3396
(732) 376-9333
Mailing address
275 HOBART ST, PERTH AMBOY, NJ 08861-3396
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26NJ00598200
APN LICENSE NUMBER
NJ
Enumeration date
02/17/2016
Last updated
01/30/2023
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