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General NPI Number Information
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NPI Number | 1104688225
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Entity Type | Organization
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Legal Business Name | MAHWAH ASC LLC
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Dates
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Enumeration Date | 01/24/2024
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 400 FRANKLIN TPKE STE 200
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City | MAHWAH
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State | NJ
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Zip | 07430-3518
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Country | US
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Telephone | 646-714-6353
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Fax |
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Provider Business Mailing Address
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Address Line | 535 E 70TH ST
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City | NEW YORK
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State | NY
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Zip | 10021-4823
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Country | US
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Telephone | 646-714-6353
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DENEE MARIE WOLF
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Credential |
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Telephone | 212-774-2021
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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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