Provider Demographics
NPI:1275669343
Name:COLON & RECTAL SURGERY, P.A.
Entity Type:Organization
Organization Name:COLON & RECTAL SURGERY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:HELBRAUN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-525-1660
Mailing Address - Street 1:20 PROSPECT AVE
Mailing Address - Street 2:SUITE 811
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1997
Mailing Address - Country:US
Mailing Address - Phone:201-525-1660
Mailing Address - Fax:201-525-1667
Practice Address - Street 1:20 PROSPECT AVE
Practice Address - Street 2:SUITE 811
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1997
Practice Address - Country:US
Practice Address - Phone:201-525-1660
Practice Address - Fax:201-525-1667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35677208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Single Specialty