Organization Active NPI

Haddon Surgical Assoc PA

  • Surgery Physician
  • Haddon Heights, NJ
National Provider Identifier
1063461374
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
HADDON SURGICAL ASSOC PA
Practice address
17 White Horse Pike
Ste 6
Haddon Heights, NJ 08035
Phone
(856) 547-5522
Fax
(856) 547-0416
NPI assigned
May 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Rodrigo R Santos, MD
Title
President Chairman of the Board
Phone
(856) 547-5522

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

17 White Horse Pike
Ste 6
Haddon Heights, NJ 08035

Mailing address

17 White Horse Pike
Ste 6
Haddon Heights, NJ 08035
Phone (856) 547-5522

Other identifiers 1

IdentifierTypeStateIssuer
1011715MedicaidNJ

National Provider Directory

National Provider Directory

Locations

17 White Horse Pike
Ste 6
Haddon Hgts, NJ 08035
Phone (609) 547-5522

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196035200000",
    "number": "1063461374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 WHITE HORSE PIKE",
            "address_2": "STE 6",
            "city": "HADDON HEIGHTS",
            "state": "NJ",
            "postal_code": "08035",
            "telephone_number": "856-547-5522",
            "fax_number": "856-547-0416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 WHITE HORSE PIKE",
            "address_2": "STE 6",
            "city": "HADDON HEIGHTS",
            "state": "NJ",
            "postal_code": "08035",
            "telephone_number": "856-547-5522",
            "fax_number": "856-547-0416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HADDON SURGICAL ASSOC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-06",
        "last_updated": "2007-11-26",
        "status": "A",
        "authorized_official_last_name": "SANTOS",
        "authorized_official_first_name": "RODRIGO",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT CHAIRMAN OF THE BOARD",
        "authorized_official_telephone_number": "856-547-5522",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011715",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Haddon Heights, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.