Provider Demographics
NPI:1700190097
Name:ACCELERATED SURGICAL CENTER OF NORTH JERSEY,LLC
Entity Type:Organization
Organization Name:ACCELERATED SURGICAL CENTER OF NORTH JERSEY,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:RAHAT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-683-3008
Mailing Address - Street 1:680 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07514-1422
Mailing Address - Country:US
Mailing Address - Phone:973-225-0723
Mailing Address - Fax:212-671-1414
Practice Address - Street 1:680 BROADWAY
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07514-1422
Practice Address - Country:US
Practice Address - Phone:973-225-0723
Practice Address - Fax:212-671-1414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical