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General NPI Number Information
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NPI Number | 1972158723
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Entity Type | Organization
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Legal Business Name | 380 SURGICAL SERVICES, LLC
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Dates
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Enumeration Date | 08/08/2019
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Last Update Date | 03/24/2025
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Provider Practice Location Address
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Address Line | 210 MEADOWLANDS PKWY STE 5
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City | SECAUCUS
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State | NJ
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Zip | 07094-2306
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Country | US
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Telephone | 301-603-2622
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Fax |
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Provider Business Mailing Address
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Address Line | 3206 TOWER OAKS BLVD STE 220
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City | ROCKVILLE
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State | MD
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Zip | 20852-4254
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Country | US
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Telephone | 301-603-2622
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Fax |
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Authorized Official
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Title or Position | GENERAL COUNSEL
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Name | EVAN HAMMERMAN
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Credential |
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Telephone | 301-652-4800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number |
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License Number State |
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