Healthcare Provider Details
I. General information
NPI: 1154311991
Provider Name (Legal Business Name): ALLIED SURGICAL GROUP, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/24/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
261 JAMES ST SUITE 2G
MORRISTOWN NJ
07960-6392
US
IV. Provider business mailing address
261 JAMES ST SUITE 2G
MORRISTOWN NJ
07960-6392
US
V. Phone/Fax
- Phone: 973-267-6400
- Fax: 973-267-7295
- Phone: 973-267-6400
- Fax: 973-267-7295
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | NJ |
VIII. Authorized Official
Name: DR.
WILLIAM
L
DIEHL
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 973-267-2817