Provider Demographics
NPI:1942594148
Name:ROCKLAND AND BERGEN SURGERY CENTER, LLC
Entity Type:Organization
Organization Name:ROCKLAND AND BERGEN SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLASCZAK
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MBA, CPC
Authorized Official - Phone:609-709-4153
Mailing Address - Street 1:133 N KINDERKAMACK RD
Mailing Address - Street 2:
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-1313
Mailing Address - Country:US
Mailing Address - Phone:201-307-4810
Mailing Address - Fax:201-307-4816
Practice Address - Street 1:133 N KINDERKAMACK RD
Practice Address - Street 2:
Practice Address - City:MONTVALE
Practice Address - State:NJ
Practice Address - Zip Code:07645-1313
Practice Address - Country:US
Practice Address - Phone:201-307-4810
Practice Address - Fax:201-307-4816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-06
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical