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General NPI Number Information
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NPI Number | 1528372612
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Entity Type | Organization
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Legal Business Name | SPECIALTY SURGERY OF SECAUCUS, LIMITED LIABILITY COMPANY
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Dates
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Enumeration Date | 07/30/2010
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Last Update Date | 07/30/2010
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Provider Practice Location Address
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Address Line | 210 MEADOWLANDS PKWY
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City | SECAUCUS
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State | NJ
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Zip | 07094-2311
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Country | US
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Telephone | 201-424-0467
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Fax | 732-865-7474
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Provider Business Mailing Address
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Address Line | 25 COMMERCE DR SUITE 350
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City | CRANFORD
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State | NJ
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Zip | 07016-3605
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Country | US
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Telephone | 908-376-2041
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Fax | 732-865-7474
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. WENDY CONDO
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Credential | RN
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Telephone | 201-424-0467
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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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