Provider Demographics
NPI:1518300102
Name:SPRINGFIELD SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:SPRINGFIELD SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMIT
Authorized Official - Middle Name:
Authorized Official - Last Name:POONIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-787-3797
Mailing Address - Street 1:105 MORRIS AVE
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-1395
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:105 MORRIS AVE
Practice Address - Street 2:1ST FLOOR
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1395
Practice Address - Country:US
Practice Address - Phone:732-952-5533
Practice Address - Fax:732-564-6722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-12
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08897700261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical