Healthcare Provider Details

I. General information

NPI: 1689726424
Provider Name (Legal Business Name): SURGICARE SURGICAL ASSOCIATES OF ENGLEWOOD CLIFFS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 08/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 PALISADE AVE
ENGLEWOOD CLIFFS NJ
07632-1842
US

IV. Provider business mailing address

85 HARRISTOWN RD
GLEN ROCK NJ
07452-3307
US

V. Phone/Fax

Practice location:
  • Phone: 201-503-1522
  • Fax: 201-503-1514
Mailing address:
  • Phone: 201-834-1100
  • Fax: 201-599-0777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. JOHN HAJJAR
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 201-503-1522