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General NPI Number Information
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NPI Number | 1194716142
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Entity Type | Organization
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Legal Business Name | ADVANCED SURGERY CENTER OF CLIFTON, LLC
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Dates
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Enumeration Date | 10/31/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1200 ROUTE 46
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City | CLIFTON
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State | NJ
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Zip | 07013-2440
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Country | US
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Telephone | 973-773-5600
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Fax | 973-773-5009
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Provider Business Mailing Address
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Address Line | 1200 ROUTE 46
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City | CLIFTON
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State | NJ
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Zip | 07013-2440
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Country | US
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Telephone | 973-773-5600
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Fax | 973-773-5009
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | KAMAL DUTTA
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Credential | M.D.
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Telephone | 973-773-5600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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