Provider Demographics
NPI:1881867190
Name:OCEAN SURGICAL ASSOCIAT
Entity Type:Organization
Organization Name:OCEAN SURGICAL ASSOCIAT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARROLL
Authorized Official - Middle Name:
Authorized Official - Last Name:CAHILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-597-6072
Mailing Address - Street 1:24 NAUTILUS DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-2490
Mailing Address - Country:US
Mailing Address - Phone:609-597-6072
Mailing Address - Fax:609-597-5255
Practice Address - Street 1:24 NAUTILUS DR
Practice Address - Street 2:SUITE 2
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2490
Practice Address - Country:US
Practice Address - Phone:609-597-6072
Practice Address - Fax:609-597-5255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA035943208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ084327Medicare PIN