Organization Name: | AMBULATORY SURGERY CENTER AT OLD BRIDGE LLC |
NPI Number: | 1043384704 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL KEEN (CFO VICE PRESIDENT OF FINANCE) |
Mailing Address: | 400 Perrine Rd Suite 408 Old Bridge |
State: | NJ US |
Postal Code: | 088572843 |
Phone Number: | 7325339222 |
Fax Number: | 7325539227 |
NPI Enumeration Date: | 11/17/2006 |
NPI Last Update Date: | 02/04/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA1903X |
License Number: | 22900 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Ambulatory Surgical |
Taxonomy Definition: |