Organization Name: | SUBURBAN ENDOSCOPY CENTER, LLC |
NPI Number: | 1275801672 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JENETHA MORAN (OFFICER/AUTHORIZED OFFICIAL) |
Mailing Address: | 799 Bloomfield Ave Suite 101 Verona |
State: | NJ US |
Postal Code: | 070441367 |
Phone Number: | 9735711600 |
Fax Number: | 9735711882 |
NPI Enumeration Date: | 12/13/2011 |
NPI Last Update Date: | 12/13/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |