1528340213 NPI number — UNIVERSITY CENTER FOR AMBULATORY SURGERY, LLC

Table of content: (NPI 1528340213)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528340213 NPI number — UNIVERSITY CENTER FOR AMBULATORY SURGERY, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY CENTER FOR AMBULATORY SURGERY, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528340213
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/05/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
85 HARRISTOWN RD
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
GLEN ROCK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07452-3307
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-834-1100
Provider Business Mailing Address Fax Number:
201-599-8338

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 WORLDS FAIR DR
Provider Second Line Business Practice Location Address:
3RD FLOOR
Provider Business Practice Location Address City Name:
SOMERSET
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08873-1369
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-748-1117
Provider Business Practice Location Address Fax Number:
732-748-1134
Provider Enumeration Date:
09/19/2011

Additional Information

Authorized Official

Authorized Official Last Name:
HAJJAR
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
H
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
201-834-1100

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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