JEWISH RENAISSANCE MEDICAL CENTER, INC. (NPI# 1124230883) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124230883 |
| Entity Type | Organization |
| Organization Name | JEWISH RENAISSANCE MEDICAL CENTER, INC. |
| Practice Address |
21 Quitman St Newark NJ 07103-4105 |
| Mailing Address |
Po Box 1220 Perth Amboy NJ 08862-1220 |
| Practice Telephone | 9734244329 |
| Mailing Telephone | 7323766635 |
| Mailing Fax Number | 7323245765 |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2009-10-20 |
| Authorized Official Name | MARK ROBERTS (CEO) |
| Authorized Official Telephone | 7323766601 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
23979 | NJ | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 0124869 | 05 | |
| NJ | 0193763 | 05 | |
| NJ | 0183252 | 05 | |
| NJ | 0751103 | 05 | |
| NJ | 8462500 | 05 | |
| NJ | 1342304 | 05 | |
| NJ | 8096201 | 05 | |
| NJ | 0115045 | 05 | |
| NJ | 0097837 | 05 | |
| NJ | 8932603 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932512092 | Jewish Renaissance Medical Center, Inc. | Clinic/Center | 120 Manchester Pl, Newark, NJ 07104-1704 | 2014-06-06 |
| 1356769277 | Jewish Renaissance Medical Center, Inc. | Clinic/Center | 258-380 Verona Avenue, Newark, NJ 07114 | 2014-03-29 |
| 1447522461 | Jewish Renaissance Medical Center, Inc. | Clinic/Center | 246 18th Ave, Newark, NJ 07108-2316 | 2012-02-07 |
| 1710199468 | Jewish Renaissance Medical Center, Inc. | Clinic/Center | 80 Johnson Ave, Newark, NJ 07108-2729 | 2007-05-04 |
| 1982087607 | Jewish Renaissance Medical Center, Inc. | Clinic/Center | 359 13th Ave, Newark, NJ 07103-2125 | 2015-06-30 |
| 1710304563 | Jewish Renaissance Medical Center, Inc. | Clinic/Center | 275 Hobart St, Perth Amboy, NJ 08861-3396 | 2014-03-18 |
| 1598090292 | Jewish Renaissance Medical Center, Inc. | Clinic/Center | 275 Hobart St, Mobile Unit, Perth Amboy, NJ 08861-4310 | 2009-10-14 |
| 1225240971 | Jewish Renaissance Medical Center, Inc. | Clinic/Center | 226 Dayton St, Newark, NJ 07114-1159 | 2007-05-04 |
| 1811109572 | Jewish Renaissance Medical Center, Inc. | Clinic/Center | 90 Parker St, Newark, NJ 07104-1028 | 2007-05-04 |
| 1225240997 | Jewish Renaissance Medical Center, Inc. | Clinic/Center | 275 Hobart St, Perth Amboy, NJ 08861 | 2007-05-04 |
| Street Address |
21 QUITMAN ST |
| City | NEWARK |
| State | NJ |
| Zip Code | 07103-4105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740205434 | Janice Bell | Dentist | 21 Quitman St, Newark, NJ 07103-4105 | 2006-07-13 |
| 1063542587 | Khadijah Ismael | Dentist | 21 Quitman St, Newark, NJ 07103-4105 | 2007-03-06 |
| 1982765574 | Moshe Rose | Psychiatry & Neurology | 21 Quitman St, Newark, NJ 07103-4105 | 2006-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124657077 | Yingna Liu | Student in an Organized Health Care Education/Training Program | Medical Science Building, 185 South Orange Avenue, Newark, NJ 07103 | 2020-04-03 |
| 1568029684 | Martins Akhibi | Nurse Practitioner | 178 Newton Street, Newark, NJ 07103 | 2019-05-23 |
| 1972168482 | Newark Renaissance House, Inc | Rehabilitation, Substance Use Disorder Unit | 50-56 Norfolk Street, Newark, NJ 07103 | 2019-05-09 |
| 1346709235 | Ian Wang Yu | Student in an Organized Health Care Education/Training Program | 185 South Orange Ave., Medical Science Building, Room I-506, Newark, NJ 07103 | 2019-03-19 |
| 1437648417 | Stephen Vanbeek | Internal Medicine | 185 S Orange Ave Rm 547, Newark, NJ 07103 | 2018-05-06 |
| 1073019444 | Geoffrey Alexander Talis | Student in an Organized Health Care Education/Training Program | 183 S. Orange Avenue, Level E, Room 1452, Newark, NJ 07103 | 2018-04-03 |
| 1285139907 | Thomas Georg Bachmann | Student in an Organized Health Care Education/Training Program | 185 South Orange Ave, Medical Science Building, G-538, Newark, NJ 07103 | 2018-03-26 |
| 1154825289 | Shammi A Patel | Student in an Organized Health Care Education/Training Program | 185 S Orange Ave # Msbg594, Newark, NJ 07103 | 2018-03-22 |
| 1982122545 | North Jersey Aids Alliance | Clinic/Center | 393 Central Avenue C/o Corey Destefano, Newark, NJ 07103 | 2017-09-05 |
| 1134655533 | Yasmin N Abedin | Student in an Organized Health Care Education/Training Program | 185 South Orange Ave, Msb E-506, Rutgers, New Jersey Medical School, Newark, NJ 07103 | 2017-05-04 |
| Find all providers in zip 07103 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538724554 | Saint James Health Inc | Clinic/Center | 332 S 8th St, Newark, NJ 07103-2173 | 2019-05-06 |
| 1366993586 | Newark Community Health Centers, Inc | Clinic/Center | 92-96 Ferry Street, Newark, NJ 07105-1817 | 2016-10-24 |
| 1477914612 | City of Newark | Clinic/Center | 30 N Munn Ave # 30a, Newark, NJ 07106-1411 | 2016-03-16 |
| 1932512092 | Jewish Renaissance Medical Center, Inc. | Clinic/Center | 120 Manchester Pl, Newark, NJ 07104-1704 | 2014-06-06 |
| 1356769277 | Jewish Renaissance Medical Center, Inc. | Clinic/Center | 258-380 Verona Avenue, Newark, NJ 07114 | 2014-03-29 |
| 1447522461 | Jewish Renaissance Medical Center, Inc. | Clinic/Center | 246 18th Ave, Newark, NJ 07108-2316 | 2012-02-07 |
| 1548431091 | Newark Community Health Centers,inc. | Clinic/Center | 982 Broad St, Newark, NJ 07102-2503 | 2008-03-12 |
| 1619148160 | Newark Community Health Centers,inc. | Clinic/Center | 516 Bergen St, Newark, NJ 07108-1639 | 2008-03-12 |
| 1770784563 | Alameda Health System | Clinic/Center | 6066 Civiv Terrace Avenue, Newark, CA 94560-3756 | 2007-05-30 |
| 1710199468 | Jewish Renaissance Medical Center, Inc. | Clinic/Center | 80 Johnson Ave, Newark, NJ 07108-2729 | 2007-05-04 |
| Find all providers in NEWARK | ||||
Please comment or provide details below to improve the information on JEWISH RENAISSANCE MEDICAL CENTER, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.