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General NPI Number Information
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NPI Number | 1073673174
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Entity Type | Organization
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Legal Business Name | ROXBURY OPEN MRI AND SURGICAL CENTER, LLC
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 06/11/2008
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Provider Practice Location Address
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Address Line | 66 SUNSET STRIP 101
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City | SUCCASUNNA
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State | NJ
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Zip | 07876-1345
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Country | US
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Telephone | 973-927-8100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 428
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City | SADDLE RIVER
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State | NJ
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Zip | 07458-0428
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Country | US
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Telephone | 973-927-8100
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JEFFREY S. LIVA
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Credential | MD
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Telephone | 973-927-8100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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