Provider Demographics
NPI:1144385493
Name:PREFERRED SURGICAL GROUP, LLC.
Entity Type:Organization
Organization Name:PREFERRED SURGICAL GROUP, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMED
Authorized Official - Middle Name:FAHMI
Authorized Official - Last Name:ALBASHIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-986-7734
Mailing Address - Street 1:PO BOX 6428
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-0428
Mailing Address - Country:US
Mailing Address - Phone:718-986-7734
Mailing Address - Fax:201-795-9157
Practice Address - Street 1:550 NEWARK AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-1326
Practice Address - Country:US
Practice Address - Phone:201-795-9155
Practice Address - Fax:201-795-9157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8578401Medicaid
NJ8578401Medicaid