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General NPI Number Information
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NPI Number | 1336112200
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Entity Type | Organization
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Legal Business Name | MERCER COUNTY SURGERY CENTER LLC
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Dates
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Enumeration Date | 02/09/2006
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Last Update Date | 10/05/2018
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Provider Practice Location Address
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Address Line | 2A PRINCESS ROAD SUITE 100
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648
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Country | US
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Telephone | 609-895-0290
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Fax | 609-895-0291
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Provider Business Mailing Address
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Address Line | 2A PRINCESS ROAD SUITE 100
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648
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Country | US
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Telephone | 609-895-0290
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Fax | 609-895-0291
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. FREDRIC KLEINBART
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Credential | M.D.
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Telephone | 609-895-0290
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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 | 23047
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License Number State | NJ
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Taxonomy #2
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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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