Healthcare Provider Details

I. General information

NPI: 1548755838
Provider Name (Legal Business Name): SURGICAL STUDIOS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2018
Last Update Date: 09/29/2022
Certification Date: 09/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 MULLICA HILL RD
MULLICA HILL NJ
08062-2655
US

IV. Provider business mailing address

199 MULLICA HILL RD
MULLICA HILL NJ
08062-2655
US

V. Phone/Fax

Practice location:
  • Phone: 856-362-8898
  • Fax: 856-362-8903
Mailing address:
  • Phone: 856-312-3110
  • Fax: 856-418-1274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DIANA C GRASSO
Title or Position: ADMINISTRATOR
Credential:
Phone: 856-312-3110