Provider Demographics
NPI:1003842626
Name:AMBULATORY CENTER FOR ENDOSCOPY, LLC
Entity Type:Organization
Organization Name:AMBULATORY CENTER FOR ENDOSCOPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:M
Authorized Official - Last Name:HOHLFELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-589-9024
Mailing Address - Street 1:2500 YORK RD STE 300
Mailing Address - Street 2:
Mailing Address - City:JAMISON
Mailing Address - State:PA
Mailing Address - Zip Code:18929-1098
Mailing Address - Country:US
Mailing Address - Phone:215-589-9024
Mailing Address - Fax:833-705-6301
Practice Address - Street 1:7600 RIVER RD
Practice Address - Street 2:4TH FLOOR
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-6217
Practice Address - Country:US
Practice Address - Phone:201-705-1080
Practice Address - Fax:201-705-1090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0852180Medicaid