Provider Demographics
NPI:1003408006
Name:CENTER FOR ADVANCED SURGICAL EXCELLENCE, LLC
Entity type:Organization
Organization Name:CENTER FOR ADVANCED SURGICAL EXCELLENCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:BALDUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BS
Authorized Official - Phone:201-264-8424
Mailing Address - Street 1:15 SUMMIT AVE
Mailing Address - Street 2:C/O JOAN BALDUCCI
Mailing Address - City:RINGWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07456
Mailing Address - Country:US
Mailing Address - Phone:201-264-8424
Mailing Address - Fax:
Practice Address - Street 1:134 RT 73
Practice Address - Street 2:BLDG B
Practice Address - City:VOORHEEES
Practice Address - State:NJ
Practice Address - Zip Code:08043
Practice Address - Country:US
Practice Address - Phone:201-264-8424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical