Organization Name: | NORTH FULLERTON SURGERY CENTER, LLC |
NPI Number: | 1043271604 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | HEIDI FACCHINI (ADMINISTRATOR) |
Mailing Address: | 37 N Fullerton Ave Montclair |
State: | NJ US |
Postal Code: | 070423426 |
Phone Number: | 9732330433 |
Fax Number: | 9732330144 |
NPI Enumeration Date: | 03/31/2006 |
NPI Last Update Date: | 12/28/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA1903X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Ambulatory Surgical |
Taxonomy Definition: |