Provider Demographics
NPI:1467681775
Name:FORT LEE MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:FORT LEE MEDICAL CENTER, INC.
Other - Org Name:FORT LEE SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-461-6666
Mailing Address - Street 1:1608 LEMOINE AVENUE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-5622
Mailing Address - Country:US
Mailing Address - Phone:201-585-9921
Mailing Address - Fax:201-585-9979
Practice Address - Street 1:1608 LEMOINE AVENUE
Practice Address - Street 2:SUITE 101
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-5622
Practice Address - Country:US
Practice Address - Phone:201-585-9921
Practice Address - Fax:201-585-9979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-08
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical