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General NPI Number Information
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NPI Number | 1457653834
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Entity Type | Organization
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Legal Business Name | SURGICARE SURGICAL ASSOCIATES OF JERSEY CITY, LLC
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Dates
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Enumeration Date | 11/17/2010
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Last Update Date | 12/10/2013
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Provider Practice Location Address
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Address Line | 631 GRAND ST
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City | JERSEY CITY
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State | NJ
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Zip | 07304-3417
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Country | US
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Telephone | 201-834-1100
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Fax | 201-599-8338
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Provider Business Mailing Address
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Address Line | 85 HARRISTOWN RD
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City | GLEN ROCK
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State | NJ
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Zip | 07452-3307
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Country | US
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Telephone | 201-834-1100
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Fax | 201-599-8338
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MR. CHRIS DALTON
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Credential |
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Telephone | 201-834-1100
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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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