Provider Demographics
NPI:1609046168
Name:WEST ORANGE NJ ENDOSCOPY ASC LLC
Entity Type:Organization
Organization Name:WEST ORANGE NJ ENDOSCOPY ASC LLC
Other - Org Name:NORTHFIELD SURGICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BILLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-665-1283
Mailing Address - Street 1:741 NORTHFIELD AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-1174
Mailing Address - Country:US
Mailing Address - Phone:973-243-1062
Mailing Address - Fax:973-243-0731
Practice Address - Street 1:741 NORTHFIELD AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052-1174
Practice Address - Country:US
Practice Address - Phone:973-243-1062
Practice Address - Fax:973-243-0731
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical