Provider Demographics
NPI:1477659555
Name:EDISON SURGICAL CENTER, L.L.C.
Entity Type:Organization
Organization Name:EDISON SURGICAL CENTER, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:LOMBARDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-452-0123
Mailing Address - Street 1:10 PARSONAGE RD
Mailing Address - Street 2:2ND FLOOR, SUITE 206
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-2429
Mailing Address - Country:US
Mailing Address - Phone:732-452-0123
Mailing Address - Fax:732-452-0126
Practice Address - Street 1:10 PARSONAGE RD
Practice Address - Street 2:2ND FLOOR, SUITE 206
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2429
Practice Address - Country:US
Practice Address - Phone:732-452-0123
Practice Address - Fax:732-452-0126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2012-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ021125261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ021125OtherPTAN