1215921051 NPI number — ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL @ RAHWAY

Table of content: EDWARD ALLEN GILL JR. MD (NPI 1518046275)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215921051 NPI number — ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL @ RAHWAY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL @ RAHWAY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215921051
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/05/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
865 STONE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RAHWAY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07065-2742
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-499-6084
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
865 STONE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RAHWAY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07065-2742
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-499-6084
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/08/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BOWBLISS
Authorized Official First Name:
BARBARA
Authorized Official Middle Name:
T.
Authorized Official Title or Position:
DIRECTOR PATIENT ACCOUNTS
Authorized Official Telephone Number:
732-499-6084

Provider Taxonomy Codes

  • Taxonomy code: 314000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 004737 . This is a "KEYSTONE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 310224 . This is a "HORISON STATE HEALTH BEN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0009811 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 001570 . This is a "WELLCHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: HO4953 . This is a "OXFORD HEALTH PLAN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 310024 . This is a "HORIZON NJ BLUE CROSS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 528957 . This is a "EMPIRE MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: IL5193 . This is a "HEALTHNET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 001570 . This is a "NYBC/WELLCHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1008954 . This is a "HORIZON NJ HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 50040 . This is a "AMERIGROUP" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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