NJSR Surgical Center, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

NJSR SURGICAL CENTER, LLC

Practice address

111 Wanaque Ave
Pompton Lakes, NJ 07442-2101

Phone

(973) 248-8818

Fax

(973) 248-8844

NPI assigned

Jul 7, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Christopher Collins Jr., RN

Title

Administrator / Don

Phone

(201) 248-8818

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1246924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273190400000",
    "number": "1457580854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WANAQUE AVE",
            "city": "POMPTON LAKES",
            "state": "NJ",
            "postal_code": "074422101",
            "telephone_number": "973-248-8818",
            "fax_number": "973-248-8844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WANAQUE AVE",
            "city": "POMPTON LAKES",
            "state": "NJ",
            "postal_code": "074422101",
            "telephone_number": "973-248-8818",
            "fax_number": "973-248-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NJSR SURGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-07",
        "last_updated": "2010-05-07",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "ADMINISTRATOR / DON",
        "authorized_official_telephone_number": "201-248-8818",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Pompton Lakes, NJ
• Providers in Pompton Lakes, NJ by specialty
• Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2010; 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.