| Organization Name: | BLOOMFIELD SURGI-CENTER, LLC |
| NPI Number: | 1013921964 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | HEATHER ARLENE HOUSER (ADMINISTRATOR) |
| Mailing Address: | 1255 Broad Street Suite 200 Bloomfield |
| State: | NJ US |
| Postal Code: | 070033061 |
| Phone Number: | 9738422150 |
| Fax Number: | 9733383545 |
| NPI Enumeration Date: | 07/28/2006 |
| NPI Last Update Date: | 01/16/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP3300X |
| License Number: | 23459 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Pain |
| Taxonomy Definition: | |