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General NPI Number Information
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NPI Number | 1962320028
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Entity Type | Organization
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Legal Business Name | ENERGY SURGICAL CONSULTANT, LLC
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Dates
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Enumeration Date | 07/07/2026
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Last Update Date | 07/07/2026
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Provider Practice Location Address
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Address Line | 12 CLOVER RD
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City | NEWFOUNDLAND
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State | NJ
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Zip | 07435-1712
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Country | US
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Telephone | 973-886-6237
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Fax |
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Provider Business Mailing Address
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Address Line | 12 CLOVER RD
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City | NEWFOUNDLAND
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State | NJ
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Zip | 07435-1712
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Country | US
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Telephone | 973-886-6237
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT
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Name | NICOLE GAREY
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Credential | MPAS, PA-C
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Telephone | 973-886-6237
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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