Healthcare Provider Details
I. General information
NPI: 1942841143
Provider Name (Legal Business Name): GLOBAL SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/30/2019
Last Update Date: 09/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
680 KINDERKAMACK RD STE 100
ORADELL NJ
07649-1600
US
IV. Provider business mailing address
680 KINDERKAMACK RD STE 100
ORADELL NJ
07649-1600
US
V. Phone/Fax
- Phone: 201-367-2273
- Fax: 201-262-2273
- Phone: 201-367-2273
- Fax: 201-262-2273
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 | |
VIII. Authorized Official
Name: MR.
DAVID
RAGHUNANDAN
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 201-367-2273