Provider Demographics
NPI:1316417314
Name:TAYLOR MEDICAL & SURGICAL SERVICES LLC
Entity Type:Organization
Organization Name:TAYLOR MEDICAL & SURGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:L
Authorized Official - Last Name:LENZ
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:609-412-9761
Mailing Address - Street 1:PO BOX 174
Mailing Address - Street 2:
Mailing Address - City:ABSECON
Mailing Address - State:NJ
Mailing Address - Zip Code:08201-0174
Mailing Address - Country:US
Mailing Address - Phone:609-412-9761
Mailing Address - Fax:
Practice Address - Street 1:44 SHADY LN
Practice Address - Street 2:
Practice Address - City:ABSECON
Practice Address - State:NJ
Practice Address - Zip Code:08201-1739
Practice Address - Country:US
Practice Address - Phone:609-412-9761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-03
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty