Healthcare Provider Details
I. General information
NPI: 1801179619
Provider Name (Legal Business Name): SURGICARE OF FREEHOLD LIMITED LIABILITY COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/28/2011
Last Update Date: 08/05/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
901 WEST MAIN STREET
FREEHOLD NJ
07728-2537
US
IV. Provider business mailing address
85 HARRISTOWN RD SUITE 200
GLEN ROCK NJ
07452-3307
US
V. Phone/Fax
- Phone: 786-251-5741
- Fax: 954-337-0518
- Phone: 201-834-1100
- Fax: 201-599-8338
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | NJ |
VIII. Authorized Official
Name: DR.
JOHN
H
HAJJAR
Title or Position: PRESIDENT/CEO
Credential: MD
Phone: 201-834-1100