Provider Demographics
NPI:1053522474
Name:TRINITAS HOSPITAL
Entity type:Organization
Organization Name:TRINITAS HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:BERTA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BURGOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-994-7560
Mailing Address - Street 1:527 NORTH AVE APT 1A
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-1736
Mailing Address - Country:US
Mailing Address - Phone:908-220-6842
Mailing Address - Fax:
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:908-994-7560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SW05125800261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health