Provider Demographics
NPI:1508898388
Name:GENERAL SURGEONS OF NORTH JERSEY PA
Entity Type:Organization
Organization Name:GENERAL SURGEONS OF NORTH JERSEY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:CLAUDE
Authorized Official - Last Name:BUDD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-742-3371
Mailing Address - Street 1:707 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07514
Mailing Address - Country:US
Mailing Address - Phone:973-742-3371
Mailing Address - Fax:973-742-3168
Practice Address - Street 1:707 BROADWAY
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514
Practice Address - Country:US
Practice Address - Phone:973-742-3371
Practice Address - Fax:973-742-3168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2693402Medicaid
NJ2693402Medicaid