Provider Demographics
NPI:1922673128
Name:SOMERSET SURGICAL ASSOCIATES,LLC
Entity Type:Organization
Organization Name:SOMERSET SURGICAL ASSOCIATES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:OBI
Authorized Official - Middle Name:J
Authorized Official - Last Name:IMEGWU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-725-2400
Mailing Address - Street 1:30 REHILL AVE STE 3400
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08876-2548
Mailing Address - Country:US
Mailing Address - Phone:908-927-8987
Mailing Address - Fax:
Practice Address - Street 1:303 GEORGE ST STE 105
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-2009
Practice Address - Country:US
Practice Address - Phone:908-725-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-21
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty