Provider Demographics
NPI:1760795025
Name:CTO MANAGEMENT
Entity Type:Organization
Organization Name:CTO MANAGEMENT
Other - Org Name:HEALTH EAST ASC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANSON
Authorized Official - Middle Name:M
Authorized Official - Last Name:MOISE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-871-4000
Mailing Address - Street 1:54 SOUTH DEAN STREET
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631
Mailing Address - Country:US
Mailing Address - Phone:201-871-4000
Mailing Address - Fax:201-871-4000
Practice Address - Street 1:54 S DEAN ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631
Practice Address - Country:US
Practice Address - Phone:201-871-4000
Practice Address - Fax:201-871-4000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-15
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical