Healthcare Provider Details

I. General information

NPI: 1952404006
Provider Name (Legal Business Name): WATCHUNG SURGICAL ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 STIRLING ROAD
WATCHUNG NJ
07069
US

IV. Provider business mailing address

40 STIRLING ROAD
WATCHUNG NJ
07069
US

V. Phone/Fax

Practice location:
  • Phone: 908-769-8000
  • Fax: 908-769-4139
Mailing address:
  • Phone: 908-769-8000
  • Fax: 908-769-4139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: ALLAN B COHEN
Title or Position: PRESIDENT & CEO
Credential: MD
Phone: 908-769-0912