| Holy Name Pavillion | |
|
718 Teaneck Rd Teaneck NJ 07666-4245 | |
| (201) 833-3000 | |
| (201) 833-4486 |
| Full Name | Holy Name Pavillion |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 718 Teaneck Rd, Teaneck, New Jersey |
| Authorized Official Name and Position | Ryan Kennedy (VP OF FINANCE) |
| Authorized Official Contact | 2018337016 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holy Name Pavillion 718 Teaneck Rd Teaneck NJ 07666-4245 Ph: (201) 833-3000 | Holy Name Pavillion 718 Teaneck Rd Teaneck NJ 07666-4245 Ph: (201) 833-3000 |
| NPI Number | 1609945963 |
|---|---|
| Provider Enumeration Date | 11/08/2006 |
| Last Update Date | 02/05/2014 |
| Medicare PECOS PAC ID | 3971665183 |
|---|---|
| Medicare Enrollment ID | O20170407001316 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609945963 | NPI | - | NPPES |
| 4135423 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 10205 (New Jersey) | Primary |
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