Healthcare Provider Details

I. General information

NPI: 1609583137
Provider Name (Legal Business Name): MUHLENBERG ASC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2022
Last Update Date: 11/03/2022
Certification Date: 11/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1280 RANDOLPH RD STE 301
PLAINFIELD NJ
07060
US

IV. Provider business mailing address

1280 RANDOLPH RD STE 301
PLAINFIELD NJ
07060
US

V. Phone/Fax

Practice location:
  • Phone: 973-429-7900
  • Fax: 856-403-4662
Mailing address:
  • Phone: 973-429-7900
  • Fax: 856-403-4662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: GEORGIANNE MAXWELL
Title or Position: PARTNER
Credential:
Phone: 856-693-7162