Provider Demographics
NPI:1922419654
Name:MED-SURG PRACTITIONERS, LLC
Entity Type:Organization
Organization Name:MED-SURG PRACTITIONERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:HAJJAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-855-8302
Mailing Address - Street 1:85 HARRISTOWN RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GLEN ROCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07452-3307
Mailing Address - Country:US
Mailing Address - Phone:201-855-8302
Mailing Address - Fax:201-444-3925
Practice Address - Street 1:85 HARRISTOWN RD
Practice Address - Street 2:SUITE 201
Practice Address - City:GLEN ROCK
Practice Address - State:NJ
Practice Address - Zip Code:07452-3307
Practice Address - Country:US
Practice Address - Phone:201-855-8302
Practice Address - Fax:201-444-3925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-15
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty