Provider Demographics
NPI:1275639023
Name:SURGICAL CENTER OF BURLINGTON COUNTY, INC
Entity Type:Organization
Organization Name:SURGICAL CENTER OF BURLINGTON COUNTY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:H
Authorized Official - Last Name:SCIMECA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-880-9000
Mailing Address - Street 1:225 SUNSET RD
Mailing Address - Street 2:
Mailing Address - City:WILLINGBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08046-1109
Mailing Address - Country:US
Mailing Address - Phone:609-880-9000
Mailing Address - Fax:609-880-1603
Practice Address - Street 1:225 SUNSET RD
Practice Address - Street 2:
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046-1109
Practice Address - Country:US
Practice Address - Phone:609-880-9000
Practice Address - Fax:609-880-1603
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9079106Medicaid
NJ091796Medicare ID - Type Unspecified
P00235933Medicare PIN