Provider Demographics
NPI:1982631883
Name:SADDLE BROOK MEDICAL CENTER PA
Entity Type:Organization
Organization Name:SADDLE BROOK MEDICAL CENTER PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:KOLLAR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:201-712-7900
Mailing Address - Street 1:383 B MARKET STREET B-4
Mailing Address - Street 2:
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663
Mailing Address - Country:US
Mailing Address - Phone:201-712-7900
Mailing Address - Fax:201-712-7902
Practice Address - Street 1:383 MARKET ST # B-4
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-5300
Practice Address - Country:US
Practice Address - Phone:201-712-7900
Practice Address - Fax:201-712-7902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-27
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ533552Medicare PIN