Provider Demographics
NPI:1417242488
Name:ENDO SURGICAL CENTER OF EAST BRUNSWICK LLC
Entity Type:Organization
Organization Name:ENDO SURGICAL CENTER OF EAST BRUNSWICK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:FOCAZIO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-591-0184
Mailing Address - Street 1:999 CLIFTON AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2711
Mailing Address - Country:US
Mailing Address - Phone:973-591-0184
Mailing Address - Fax:973-591-0178
Practice Address - Street 1:41 ARTHUR ST
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3712
Practice Address - Country:US
Practice Address - Phone:973-591-0184
Practice Address - Fax:973-591-0178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical