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General NPI Number Information
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NPI Number | 1477722932
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Entity Type | Organization
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Legal Business Name | GENERAL SURGERY OF BERGEN-PASSAIC, P.A.
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Dates
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Enumeration Date | 02/28/2008
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Last Update Date | 02/28/2008
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Provider Practice Location Address
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Address Line | 1100 CLIFTON AVE SUITE 2B
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City | CLIFTON
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State | NJ
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Zip | 07013-3631
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Country | US
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Telephone | 973-778-0100
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Fax | 973-778-2029
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Provider Business Mailing Address
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Address Line | 1360 CLIFTON AVE P.O. BOX 335
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City | CLIFTON
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State | NJ
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Zip | 07012-1343
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Country | US
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Telephone | 973-778-0100
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Fax | 973-778-2029
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Authorized Official
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Title or Position | OWNER
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Name | DR. EDWIN P KANE II
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Credential | M.D.
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Telephone | 973-778-0100
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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 | MA41755
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License Number State | NJ
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