Healthcare Provider Details

I. General information

NPI: 1306928916
Provider Name (Legal Business Name): FREEHOLD SURGICAL CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 02/05/2024
Certification Date: 06/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 W MAIN ST
FREEHOLD NJ
07728-2500
US

IV. Provider business mailing address

420 MOUNTAIN AVE FL 4 4TH FLOOR
NEW PROVIDENCE NJ
07974-2736
US

V. Phone/Fax

Practice location:
  • Phone: 732-462-8707
  • Fax: 732-780-3699
Mailing address:
  • Phone: 908-458-8333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number StateNJ

VIII. Authorized Official

Name: LAUREN MAGNIFICO
Title or Position: VP ASC OPERATIONS
Credential:
Phone: 201-216-1700