Healthcare Provider Details

I. General information

NPI: 1205875283
Provider Name (Legal Business Name): RWJ ENDOSURGICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 08/20/2025
Certification Date: 08/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 RYDERS LN
EAST BRUNSWICK NJ
08816-5849
US

IV. Provider business mailing address

800 RYDERS LN
EAST BRUNSWICK NJ
08816-5849
US

V. Phone/Fax

Practice location:
  • Phone: 732-432-6880
  • Fax:
Mailing address:
  • Phone: 732-432-6880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number22700
License Number StateNJ

VIII. Authorized Official

Name: ALENE STEWART
Title or Position: VP
Credential:
Phone: 615-656-0918