Provider Demographics
NPI:1992024095
Name:LAPAROSCOPIC EDGE, PC
Entity Type:Organization
Organization Name:LAPAROSCOPIC EDGE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOYAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-541-0605
Mailing Address - Street 1:PO BOX 648
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-0648
Mailing Address - Country:US
Mailing Address - Phone:908-481-1270
Mailing Address - Fax:908-688-8861
Practice Address - Street 1:700 RAHWAY AVE
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-6634
Practice Address - Country:US
Practice Address - Phone:908-481-1270
Practice Address - Fax:908-688-8861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-28
Last Update Date:2010-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty