Healthcare Provider Details

I. General information

NPI: 1922575935
Provider Name (Legal Business Name): MATRIX SURGICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2018
Last Update Date: 10/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 ROUTE 17 NORTH SUITE 105
PARAMUS NJ
07652-2815
US

IV. Provider business mailing address

140 N RTE 17 STE 105
PARAMUS NJ
07652-2815
US

V. Phone/Fax

Practice location:
  • Phone: 201-225-1101
  • Fax: 201-225-1106
Mailing address:
  • Phone: 201-225-1101
  • Fax:

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: DR. MARTIN J. MOSKOVITZ
Title or Position: OWNER
Credential: MD
Phone: 201-788-7912