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General NPI Number Information
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NPI Number | 1780555060
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Entity Type | Organization
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Legal Business Name | NORTHEAST SURGICAL SPECIALISTS OF NJ PC
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Dates
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Enumeration Date | 09/17/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 140 SYLVAN AVE STE 213
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City | ENGLEWOOD CLIFFS
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State | NJ
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Zip | 07632-2559
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Country | US
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Telephone | 718-626-0707
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Fax | 718-545-0333
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Provider Business Mailing Address
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Address Line | 40 BERRY HILL RD
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City | OYSTER BAY
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State | NY
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Zip | 11771-3515
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Country | US
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Telephone | 718-626-0707
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Fax | 718-545-0333
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Authorized Official
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Title or Position | OWNER
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Name | PANAGIOTIS MANOLAS
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Credential | MD
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Telephone | 718-626-0707
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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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