Healthcare Provider Details

I. General information

NPI: 1194716191
Provider Name (Legal Business Name): AMBULATORY SURGICAL CENTER OF UNION COUNTY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 09/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 W CHESTNUT ST SUITE 200
UNION NJ
07083-6950
US

IV. Provider business mailing address

950 W CHESTNUT ST SUITE 200
UNION NJ
07083-6950
US

V. Phone/Fax

Practice location:
  • Phone: 908-688-2700
  • Fax: 908-688-7424
Mailing address:
  • Phone: 908-688-2700
  • Fax: 908-688-7424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number23028
License Number StateNJ

VIII. Authorized Official

Name: MARCY SASSO
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 908-688-2700