Basic Information
| Provider Information | |||||||||
| NPI: | 1255728499 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SUMMIT ATLANTIC SURGERY CENTER LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 140 PARK AVENUE | ||||||||
| Address2: | |||||||||
| City: | FLORHAM PARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079321049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9082734300 | ||||||||
| FaxNumber: | 9087906576 | ||||||||
| Practice Location | |||||||||
| Address1: | 140 PARK AVENUE | ||||||||
| Address2: | |||||||||
| City: | FLORHAM PARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 079321049 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9082734300 | ||||||||
| FaxNumber: | 9087906576 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/24/2015 | ||||||||
| LastUpdateDate: | 07/16/2015 | ||||||||
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| AuthorizedOfficialLastName: | SAUNDERS | ||||||||
| AuthorizedOfficialFirstName: | PETER | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF REVENUE CYCLE | ||||||||
| AuthorizedOfficialTelephone: | 9082734300 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.