Provider Demographics
NPI:1326083346
Name:AAA COMMUNITY SURGCAL
Entity Type:Organization
Organization Name:AAA COMMUNITY SURGCAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:FRIED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-349-2990
Mailing Address - Street 1:PO BOX 4686
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08754-4686
Mailing Address - Country:US
Mailing Address - Phone:732-349-2990
Mailing Address - Fax:
Practice Address - Street 1:9 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6425
Practice Address - Country:US
Practice Address - Phone:732-349-1400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ5419220003332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ5419220003Medicare ID - Type Unspecified