Healthcare Provider Details

I. General information

NPI: 1952626640
Provider Name (Legal Business Name): SALARTASH SURGICAL ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2010
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 CENTRAL AVE STE D
EGG HARBOR TOWNSHIP NJ
08234-8347
US

IV. Provider business mailing address

301 CENTRAL AVE STE D
EGG HARBOR TOWNSHIP NJ
08234-8347
US

V. Phone/Fax

Practice location:
  • Phone: 609-926-5000
  • Fax: 609-926-2020
Mailing address:
  • Phone: 609-926-5000
  • Fax: 609-926-2020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberNJ31562
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberMA05921
License Number StateNJ

VIII. Authorized Official

Name: KHASHAYAR SALARTASH
Title or Position: PRESIDENT, MANAGING PHYSICIAN
Credential: MD
Phone: 609-926-5000