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General NPI Number Information
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NPI Number | 1154673556
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Entity Type | Organization
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Legal Business Name | SADDLE SURGERY CENTER CORP
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Dates
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Enumeration Date | 10/09/2012
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Last Update Date | 07/10/2014
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Provider Practice Location Address
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Address Line | 8 SADDLE RD SUITE 204
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City | CEDAR KNOLLS
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State | NJ
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Zip | 07927-1902
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Country | US
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Telephone | 973-998-7868
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Fax | 973-998-7883
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Provider Business Mailing Address
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Address Line | 8 SADDLE RD SUITE 204
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City | CEDAR KNOLLS
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State | NJ
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Zip | 07927-1902
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Country | US
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Telephone | 973-998-7868
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Fax | 973-998-7883
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Authorized Official
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Title or Position | MANAGER
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Name | IRINA KAMENETSKIY
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Credential |
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Telephone | 973-998-7868
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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 | 25MA07903700
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License Number State | NJ
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