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General NPI Number Information
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NPI Number | 1902836299
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Entity Type | Organization
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Legal Business Name | MORRISTOWN SURGICAL CTR. @ MADISON AVE. LLC
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 02/10/2014
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Provider Practice Location Address
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Address Line | 111 MADISON AVE SUITE 401
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City | MORRISTOWN
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State | NJ
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Zip | 07960-6097
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Country | US
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Telephone | 973-971-6970
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Fax |
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Provider Business Mailing Address
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Address Line | 200 THE AMERICAN RD
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City | MORRIS PLAINS
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State | NJ
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Zip | 07950-2449
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DAVID FERGUSON
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Credential |
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Telephone | 973-401-6788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0800X
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Taxonomy Name | Endoscopy Clinic/Center
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License Number | 24052
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License Number State | NJ
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