Organization Active NPI

Aesthetic and Reconstructive Surgery, L.L.C.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Madison, NJ
National Provider Identifier
1679938740
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
DI16442 Issued in NJ
Legal business name
AESTHETIC AND RECONSTRUCTIVE SURGERY, L.L.C.
Practice address
100 Kings Rd
Madison, NJ 07940-2670
Phone
(973) 966-6699
Fax
(973) 966-6619
NPI assigned
Dec 16, 2015
Last updated
Feb 11, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

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

Authorized official

Name
Dr. Lawrence Mark Gorzelnik, M.D., D.M.D.NPI 1235262064
Title
Director
Phone
(973) 966-6699

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.)Group: 193400000X SINGLE SPECIALTY GROUP 204E00000X DI16442 NJ Primary

Addresses

Primary practice location

100 Kings Rd
Madison, NJ 07940-2670

Mailing address

100 Kings Rd
Madison, NJ 07940-2670
Phone (973) 966-6699

National Provider Directory

National Provider Directory

Locations

100 Kings Rd
#H
Madison, NJ 07940
Phone (973) 966-6699

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1450224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455148800000",
    "number": "1679938740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KINGS RD",
            "city": "MADISON",
            "state": "NJ",
            "postal_code": "079402670",
            "telephone_number": "973-966-6699",
            "fax_number": "973-966-6619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 KINGS RD",
            "city": "MADISON",
            "state": "NJ",
            "postal_code": "079402670",
            "telephone_number": "973-966-6699",
            "fax_number": "973-966-6619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AESTHETIC AND RECONSTRUCTIVE SURGERY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-16",
        "last_updated": "2016-02-11",
        "status": "A",
        "authorized_official_last_name": "GORZELNIK",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "MARK",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "973-966-6699",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., D.M.D."
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NJ",
            "license": "DI16442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2016; 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.