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General NPI Number Information
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NPI Number | 1811299530
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Entity Type | Organization
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Legal Business Name | KOCSIS SURGICAL SERVICES LLC
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Dates
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Enumeration Date | 12/01/2010
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Last Update Date | 08/12/2011
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Provider Practice Location Address
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Address Line | 1451 ROUTE 34 SUITE 304
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City | WALL TOWNSHIP
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State | NJ
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Zip | 07727-1612
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Country | US
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Telephone | 732-453-7200
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Fax | 732-453-7277
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Provider Business Mailing Address
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Address Line | 1451 ROUTE 34 SUITE 304
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City | WALL TOWNSHIP
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State | NJ
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Zip | 07727-1612
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Country | US
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Telephone | 732-453-7200
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Fax | 732-453-7277
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. MELISSA FOGEL
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Credential |
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Telephone | 732-453-7200
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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 | 25MA05156400
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License Number State | NJ
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