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General NPI Number Information
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NPI Number | 1396050548
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Entity Type | Organization
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Legal Business Name | ABC SURGICAL ASSOCIATES LLC
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Dates
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Enumeration Date | 08/12/2010
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Last Update Date | 08/12/2010
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Provider Practice Location Address
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Address Line | 5 FRANKLIN AVE SUITE 406
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City | BELLEVILLE
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State | NJ
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Zip | 07109-3532
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Country | US
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Telephone | 973-759-4490
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Fax |
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Provider Business Mailing Address
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Address Line | 5 FRANKLIN AVE SUITE 406
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City | BELLEVILLE
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State | NJ
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Zip | 07109-3532
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Country | US
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Telephone | 973-759-4490
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Fax |
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Authorized Official
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Title or Position | PRESIDENT OF LLC
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Name | JORGE LOPEZ-CANINO
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Credential |
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Telephone | 973-759-4490
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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