MEDICARE: SURGICARE OF CENTRAL JERSEY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center		NJ

General Provider Information

NPI Number	:	1972526242
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SURGICARE OF CENTRAL JERSEY, LLC

Provider Business Mailing Address
First Line	:	40 STIRLING RD
Second Line	:	SUITE 205
City	:	WATCHUNG
State	:	NJ
Zip	:	07069-5900
Country	:	US
Telephone Number	:	908-769-0912
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 STIRLING RD
Second Line	:
City	:	WATCHUNG
State	:	NJ
Zip	:	07069-5900
Country	:	US
Telephone Number	:	908-769-0912
Fax Number	:

Authorized Official
Title or Position	:	CHIEF ADMINISTRATIVE OFFICER
Name	:	MELISSA MUNDY
Credential	:
Telephone Number	:	908-769-1354

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	10/03/2018

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