Healthcare Provider Details

I. General information

NPI: 1659731933
Provider Name (Legal Business Name): SURGICORE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2016
Last Update Date: 06/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 MARKET ST
SADDLE BROOK NJ
07663-5996
US

IV. Provider business mailing address

444 MARKET ST
SADDLE BROOK NJ
07663-5996
US

V. Phone/Fax

Practice location:
  • Phone: 201-843-9441
  • Fax: 201-843-9442
Mailing address:
  • Phone: 201-843-9441
  • Fax: 201-843-9442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number22615
License Number StateNJ

VIII. Authorized Official

Name: MR. AMAURY ROMERO
Title or Position: MANAGING PARTNER
Credential:
Phone: 973-897-5385