Provider Demographics
NPI:1477933323
Name:CHILDREN'S SURGICAL ASSOCIATES OF NEW JERSEY INC
Entity Type:Organization
Organization Name:CHILDREN'S SURGICAL ASSOCIATES OF NEW JERSEY INC
Other - Org Name:CSANJ-SPORTS MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:FLOCCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-425-9538
Mailing Address - Street 1:100 E PENN SQ
Mailing Address - Street 2:THE WANAMAKER BLDG. 9TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-3323
Mailing Address - Country:US
Mailing Address - Phone:267-425-9538
Mailing Address - Fax:267-425-9552
Practice Address - Street 1:1012 LAUREL OAKS ROAD
Practice Address - Street 2:
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-3505
Practice Address - Country:US
Practice Address - Phone:856-435-1300
Practice Address - Fax:856-435-0091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080S0010XAllopathic & Osteopathic PhysiciansPediatricsSports MedicineGroup - Multi-Specialty