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General NPI Number Information
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NPI Number | 1073495768
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Entity Type | Organization
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Legal Business Name | NORTHEAST ASC PARTNERS LLC
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Dates
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Enumeration Date | 07/23/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 475 ROUTE 70 STE 201
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5897
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Country | US
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Telephone | 832-719-8806
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Fax |
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Provider Business Mailing Address
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Address Line | 1720 HIGHWAY 34
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City | WALL TOWNSHIP
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State | NJ
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Zip | 07727-3991
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Country | US
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Telephone | 732-749-3900
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Fax |
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Authorized Official
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Title or Position | ATTORNEY
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Name | ROBERT FORD
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Credential |
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Telephone | 732-615-7242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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