Healthcare Provider Details

I. General information

NPI: 1356159909
Provider Name (Legal Business Name): NEW JERSEY PLASTIC SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2024
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 ROUTE 24 STE 3K
CHESTER NJ
07930-2910
US

IV. Provider business mailing address

385 ROUTE 24 STE 3K
CHESTER NJ
07930-2910
US

V. Phone/Fax

Practice location:
  • Phone: 908-879-2222
  • Fax:
Mailing address:
  • Phone: 908-879-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MATTHEW URBAN
Title or Position: OWNER
Credential: MD
Phone: 443-926-4937