Provider Demographics
NPI:1609585827
Name:PREMIER SURGERY CENTER OF CLIFTON LLC
Entity Type:Organization
Organization Name:PREMIER SURGERY CENTER OF CLIFTON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DELVECCHIO
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:973-354-2484
Mailing Address - Street 1:999 CLIFTON AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07013-2711
Mailing Address - Country:US
Mailing Address - Phone:973-354-2484
Mailing Address - Fax:973-354-2575
Practice Address - Street 1:999 CLIFTON AVE FL 2
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-2711
Practice Address - Country:US
Practice Address - Phone:973-354-2484
Practice Address - Fax:973-354-2575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-16
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical