Basic Information
| Provider Information | |||||||||
| NPI: | 1992198774 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DOCTOR'S SURGICAL CENTER OF NJ | ||||||||
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| Mailing Information | |||||||||
| Address1: | 160 AVENUE AT THE CMN | ||||||||
| Address2: | |||||||||
| City: | SHREWSBURY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077024802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7323800200 | ||||||||
| FaxNumber: | 7323580676 | ||||||||
| Practice Location | |||||||||
| Address1: | 160 AVENUE AT THE CMN | ||||||||
| Address2: | |||||||||
| City: | SHREWSBURY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 077024802 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7323800200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/18/2015 | ||||||||
| LastUpdateDate: | 03/31/2015 | ||||||||
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| AuthorizedOfficialLastName: | GULKO | ||||||||
| AuthorizedOfficialFirstName: | EDWARD | ||||||||
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| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 7329302447 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.