Healthcare Provider Details

I. General information

NPI: 1538414719
Provider Name (Legal Business Name): SOMERSET SURGICAL ASSOCIATES,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2012
Last Update Date: 04/03/2023
Certification Date: 04/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 REHILL AVE SUITE 3400
SOMERVILLE NJ
08876-2500
US

IV. Provider business mailing address

30 REHILL AVE SUITE 3400
SOMERVILLE NJ
08876-2500
US

V. Phone/Fax

Practice location:
  • Phone: 908-725-2400
  • Fax: 908-927-8990
Mailing address:
  • Phone: 908-725-2400
  • Fax: 908-927-8990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CYNTHIA LEE
Title or Position: PRESIDENT
Credential: MD
Phone: 908-725-2400