Shore Surgical Professional Associates

Primary specialty

SpecialistTaxonomy code 174400000X

License

MA14407 Issued in NJ

Legal business name

SHORE SURGICAL PROFESSIONAL ASSOCIATES

Practice address

705 White Horse Pike
Absecon, NJ 08201-1468

Phone

(609) 646-1739

Fax

(609) 646-7247

NPI assigned

Oct 23, 2006

Last updated

May 5, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. George C Godfrey, MD

Title

General Trauma Surgeryoccupational

Phone

(609) 646-1739

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1241481600000",
    "number": "1679656813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 WHITE HORSE PIKE",
            "city": "ABSECON",
            "state": "NJ",
            "postal_code": "082011468",
            "telephone_number": "609-646-1739",
            "fax_number": "609-646-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 WHITE HORSE PIKE",
            "city": "ABSECON",
            "state": "NJ",
            "postal_code": "082011468",
            "telephone_number": "609-646-1739",
            "fax_number": "609-646-7247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE SURGICAL PROFESSIONAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2009-05-05",
        "status": "A",
        "authorized_official_last_name": "GODFREY",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "GENERAL TRAUMA SURGERYOCCUPATIONAL",
        "authorized_official_telephone_number": "609-646-1739",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NJ",
            "license": "MA14407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3099202",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vijay R Sankhla, M.D.
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• Lynn Stein

• Specialist in Absecon, NJ
• Providers in Absecon, NJ by specialty
• Specialist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2009; 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.