| Organization Name: | MT LAUREL ENDOSCOPY CENTER L P |
| NPI Number: | 1144275900 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN J KRAVITZ (MEDICAL DIRECTOR) |
| Mailing Address: | 15000 Midlantic Dr Suite 110 Mount Laurel |
| State: | NJ US |
| Postal Code: | 080541573 |
| Phone Number: | 8569964001 |
| Fax Number: | 8569964002 |
| NPI Enumeration Date: | 05/23/2006 |
| NPI Last Update Date: | 04/10/2015 |
| 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: | |