Provider Demographics
NPI:1447505524
Name:HOTEL TRADES
Entity type:Organization
Organization Name:HOTEL TRADES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:STAFF NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:THERESA
Authorized Official - Last Name:CINTORINO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:201-914-2016
Mailing Address - Street 1:10 COLUMBUS DR
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-4362
Mailing Address - Country:US
Mailing Address - Phone:201-436-3164
Mailing Address - Fax:
Practice Address - Street 1:10 COLUMBUS DR
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-4362
Practice Address - Country:US
Practice Address - Phone:201-436-3164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-16
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY481196-1305S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305S00000XManaged Care OrganizationsPoint of Service