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General NPI Number Information
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NPI Number | 1093731101
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Entity Type | Organization
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Legal Business Name | EAST BRUNSWICK SURGERY CENTER LLC
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 12/16/2008
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Provider Practice Location Address
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Address Line | 561 CRANBURY ROAD
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-5400
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Country | US
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Telephone | 732-390-4300
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Fax | 732-390-0556
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Provider Business Mailing Address
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Address Line | 561 CRANBURY ROAD
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-5400
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Country | US
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Telephone | 732-390-4300
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Fax | 732-390-0556
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CHRISTINE REILLY
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Credential | RN MAS CNOR
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Telephone | 732-390-4300
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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 | 71274
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License Number State | NJ
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