Healthcare Provider Details

I. General information

NPI: 1205235256
Provider Name (Legal Business Name): AMERICAN AMBULATORY SURGICAL CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2014
Last Update Date: 02/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 KINDERKAMACK RD SUITE 100
ORADELL NJ
07649-1600
US

IV. Provider business mailing address

680 KINDERKAMACK RD SUITE 100
ORADELL NJ
07649-1600
US

V. Phone/Fax

Practice location:
  • Phone: 201-367-2273
  • Fax: 201-367-2007
Mailing address:
  • Phone: 201-367-2273
  • Fax: 201-367-2007

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: MR. DAVID RAGHUNANDAN
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 201-367-2273