Provider Demographics
NPI:1154311991
Name:ALLIED SURGICAL GROUP, PA
Entity Type:Organization
Organization Name:ALLIED SURGICAL GROUP, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:L
Authorized Official - Last Name:DIEHL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-267-2817
Mailing Address - Street 1:261 JAMES ST
Mailing Address - Street 2:SUITE 2G
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6392
Mailing Address - Country:US
Mailing Address - Phone:973-267-6400
Mailing Address - Fax:973-267-7295
Practice Address - Street 1:261 JAMES ST
Practice Address - Street 2:SUITE 2G
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6392
Practice Address - Country:US
Practice Address - Phone:973-267-6400
Practice Address - Fax:973-267-7295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ026054Medicare ID - Type Unspecified