Provider Demographics
NPI:1255022893
Name:HACKENSACK MERIDIAN LTACH LLC
Entity type:Organization
Organization Name:HACKENSACK MERIDIAN LTACH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-324-4714
Mailing Address - Street 1:399 THORNALL ST FL 2
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-2236
Mailing Address - Country:US
Mailing Address - Phone:732-687-8785
Mailing Address - Fax:
Practice Address - Street 1:530 NEW BRUNSWICK AVE.
Practice Address - Street 2:4TH FLOOR/GREEN
Practice Address - City:PERTH AMBOY
Practice Address - State:NJ
Practice Address - Zip Code:08861-3654
Practice Address - Country:US
Practice Address - Phone:732-324-4714
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital