Provider Demographics
NPI:1467641175
Name:EASTERN SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:EASTERN SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IRVING
Authorized Official - Middle Name:D
Authorized Official - Last Name:STRAUCHLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-882-0600
Mailing Address - Street 1:1099 BLOOMFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-7129
Mailing Address - Country:US
Mailing Address - Phone:973-882-0600
Mailing Address - Fax:973-882-0602
Practice Address - Street 1:1099 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:WEST CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-7129
Practice Address - Country:US
Practice Address - Phone:973-882-0600
Practice Address - Fax:973-882-0602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA03440300207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ527714OtherMEDICARE GROUP
NJ0371650001Medicare NSC