Organization Name: | SURGICARE SURGICAL ASSOCIATES OF CARLSTADT, LLC |
NPI Number: | 1780737239 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KEVIN BASRALIAN (MEDICAL DIRECTOR) |
Mailing Address: | 630 Broad St Carlstadt |
State: | NJ US |
Postal Code: | 070721169 |
Phone Number: | 2013551700 |
Fax Number: | 2013551694 |
NPI Enumeration Date: | 01/19/2007 |
NPI Last Update Date: | 06/26/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA1903X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Ambulatory Surgical |
Taxonomy Definition: |