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General NPI Number Information
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NPI Number | 1629841614
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Entity Type | Organization
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Legal Business Name | CNJ SPECIALTY SURGICAL ASSOCIATE
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Dates
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Enumeration Date | 11/01/2023
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Last Update Date | 11/03/2023
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Provider Practice Location Address
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Address Line | 10 INDUSTRIAL WAY E
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City | EATONTOWN
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State | NJ
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Zip | 07724-3332
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Country | US
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Telephone | 732-389-1331
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Fax |
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Provider Business Mailing Address
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Address Line | 379 CAMPUS DR FL 4
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City | SOMERSET
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State | NJ
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Zip | 08873-1161
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Country | US
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Telephone | 483-361-7898
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Fax |
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Authorized Official
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Title or Position | MBR
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Name | ROY DRESSNER
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Credential |
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Telephone | 732-389-1331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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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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