Provider Demographics
NPI:1255916508
Name:TRINITAS REGIONAL MEDICAL CENTER
Entity type:Organization
Organization Name:TRINITAS REGIONAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BUDGET AND REIMB.
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-994-8119
Mailing Address - Street 1:225 WILLIAMSON ST
Mailing Address - Street 2:FINANCE-CRANFORD
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07202-3625
Mailing Address - Country:US
Mailing Address - Phone:908-994-8119
Mailing Address - Fax:908-994-8137
Practice Address - Street 1:654 E JERSEY ST FL 2
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07206-1261
Practice Address - Country:US
Practice Address - Phone:908-994-7188
Practice Address - Fax:908-994-7377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children