Healthcare Provider Details

I. General information

NPI: 1437676988
Provider Name (Legal Business Name): CH AMBULATORY SURGERY CENTER OF LOPATCONG LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2017
Last Update Date: 08/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 RED SCHOOL LN
PHILLIPSBURG NJ
08865-2277
US

IV. Provider business mailing address

3435 WINCHESTER RD
ALLENTOWN PA
18104-2268
US

V. Phone/Fax

Practice location:
  • Phone: 610-861-8080
  • Fax:
Mailing address:
  • Phone: 610-861-8080
  • Fax: 610-849-1013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: EMIL DIIORIO
Title or Position: CEO
Credential: MD
Phone: 610-861-8080