Provider Demographics
NPI:1336204668
Name:PHYSICIANS SURGICENTER LLC
Entity Type:Organization
Organization Name:PHYSICIANS SURGICENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE COMPLIANCE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:STURZEBECHER
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:732-349-8454
Mailing Address - Street 1:1 PLAZA DR
Mailing Address - Street 2:UNIT 2
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08757-3761
Mailing Address - Country:US
Mailing Address - Phone:732-818-0059
Mailing Address - Fax:732-818-9997
Practice Address - Street 1:1 PLAZA DR
Practice Address - Street 2:UNIT 2
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08757-3761
Practice Address - Country:US
Practice Address - Phone:732-818-0059
Practice Address - Fax:732-818-9997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical