| Organization Name: | SURGICAL CENTER AT MILLBURN, LLC |
| NPI Number: | 1114034006 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PHILLIP A CLENDENIN (PESIDENT) |
| Mailing Address: | 37 E Willow St Millburn |
| State: | NJ US |
| Postal Code: | 070411416 |
| Phone Number: | 9739128111 |
| Fax Number: | 9739120181 |
| NPI Enumeration Date: | 08/24/2006 |
| NPI Last Update Date: | 04/15/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 23110 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |