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NPI Code Detail

MEDICARE: ATLANTIC COASTAL SURGERY CENTER LLC

MEDICARE: ATLANTIC COASTAL SURGERY CENTER LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QA1903XAmbulatory Surgical Clinic/Center22326NJ

General Provider Information

NPI Number : 1316992761
Entity Type Code : Organization
Provider Name (Legal Business Name) : ATLANTIC COASTAL SURGERY CENTER LLC
Provider Business Mailing Address
First Line : 301 CENTRAL AVE STE A
Second Line :
City : EGG HARBOR TOWNSHIP
State : NJ
Zip : 08234-8347
Country : US
Telephone Number : 609-653-9000
Fax Number : 609-653-6100
Provider Business Practice Location Address
First Line : 301 CENTRAL AVE STE A
Second Line :
City : EGG HARBOR TOWNSHIP
State : NJ
Zip : 08234-8347
Country : US
Telephone Number : 609-653-9000
Fax Number : 609-653-6100
Authorized Official
Title or Position : MEDICAL DIRECTOR
Name : KHASHAYAR SALARTASH
Credential : MD
Telephone Number : 609-926-5000
Provider Enumeration Date : 05/24/2006
Last Update Date : 01/26/2021

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Directions to “ATLANTIC COASTAL SURGERY CENTER LLC ” Practice Location

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