Healthcare Provider Details
I. General information
NPI: 1447240296
Provider Name (Legal Business Name): JAMES STREET SURGICAL SUITE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/24/2005
Last Update Date: 08/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
261 JAMES ST SUITE 3E
MORRISTOWN NJ
07960-6392
US
IV. Provider business mailing address
261 JAMES ST SUITE 3E
MORRISTOWN NJ
07960-6392
US
V. Phone/Fax
- Phone: 973-267-6400
- Fax: 973-267-2817
- Phone: 973-267-6400
- Fax: 973-267-2817
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.
CAREY
DOLGIN
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 973-267-2817