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General NPI Number Information
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NPI Number | 1891701611
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Entity Type | Organization
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Legal Business Name | ESSEX ENDOSCOPY CENTER LLC
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 09/26/2022
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Provider Practice Location Address
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Address Line | 275 CHESTNUT ST
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City | NEWARK
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State | NJ
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Zip | 07105-1570
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Country | US
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Telephone | 973-589-5545
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Fax | 973-589-0073
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Provider Business Mailing Address
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Address Line | 1A BURTON HILLS BLVD. ATTN: L&C
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City | NASHVILLE
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State | TN
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Zip | 37215-6187
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Country | US
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Telephone | 615-665-1283
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Fax | 615-234-1720
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEFFREY E. SNODGRASS
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Credential |
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Telephone | 615-665-1283
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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 | 22810
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License Number State | NJ
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