Healthcare Provider Details

I. General information

NPI: 1922055235
Provider Name (Legal Business Name): SEIDENBERG PROTZKO SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 BEARDS HILL RD SUITE 700
ABERDEEN MD
21001-2232
US

IV. Provider business mailing address

420 MOUNTAIN AVE FL 4
NEW PROVIDENCE NJ
07974-2736
US

V. Phone/Fax

Practice location:
  • Phone: 410-273-9096
  • Fax: 410-273-9146
Mailing address:
  • Phone: 908-458-8313
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberA1432
License Number StateMD

VIII. Authorized Official

Name: STEVEN MADREPERLA
Title or Position: PRESIDENT/CEO
Credential: MD, PHD
Phone: 908-458-8333