| Organization Name: | HANOVER NJ ENDOSCOPY ASC LLC |
| NPI Number: | 1477584621 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PHILLIP CLENDENIN (PRESIDENT) |
| Mailing Address: | 91 S Jefferson Rd Suite 300 Whippany |
| State: | NJ US |
| Postal Code: | 079811037 |
| Phone Number: | 9739296800 |
| Fax Number: | 9739296767 |
| NPI Enumeration Date: | 07/06/2006 |
| NPI Last Update Date: | 12/02/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 24075 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |