Healthcare Provider Details

I. General information

NPI: 1609674399
Provider Name (Legal Business Name): CHILDREN'S SURGICAL ASSOCIATES OF NEW JERSEY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2025
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 LAUREL OAK RD
VOORHEES NJ
08043-3505
US

IV. Provider business mailing address

3401 CIVIC CENTER BLVD
PHILADELPHIA PA
19104-4319
US

V. Phone/Fax

Practice location:
  • Phone: 856-435-1300
  • Fax: 267-425-9552
Mailing address:
  • Phone: 267-425-9538
  • Fax: 267-425-9552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: LINDA C FLOCCO
Title or Position: VICE CHAIR ADMINISTRATOR
Credential:
Phone: 215-590-2700