Provider Demographics
NPI:1164561064
Name:HUNTERDON CENTER FOR SURGERY, LLC
Entity Type:Organization
Organization Name:HUNTERDON CENTER FOR SURGERY, LLC
Other - Org Name:SURGERY TODAY
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:JERKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-806-7017
Mailing Address - Street 1:9100 WESCOTT DR STE 201
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-4677
Mailing Address - Country:US
Mailing Address - Phone:908-806-7017
Mailing Address - Fax:908-806-2838
Practice Address - Street 1:9100 WESCOTT DR STE 201
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4677
Practice Address - Country:US
Practice Address - Phone:908-806-7017
Practice Address - Fax:908-806-2838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-06
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ80336261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6758801Medicaid
NJ311052Medicare ID - Type Unspecified