Healthcare Provider Details

I. General information

NPI: 1609907211
Provider Name (Legal Business Name): SHREWSBURY SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 01/16/2025
Certification Date: 01/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 SHREWSBURY AVE
SHREWSBURY NJ
07702-4179
US

IV. Provider business mailing address

655 SHREWSBURY AVE
SHREWSBURY NJ
07702-4179
US

V. Phone/Fax

Practice location:
  • Phone: 732-450-6000
  • Fax: 732-450-6010
Mailing address:
  • Phone: 732-450-6000
  • Fax: 732-450-6010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number22616
License Number StateNJ

VIII. Authorized Official

Name: JONATHAN BAILEY
Title or Position: OFFICER/AUTHORIZED OFFICIAL
Credential:
Phone: 203-609-1168