Main Avenue Clifton Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MAIN AVENUE CLIFTON SURGERY CENTER, LLC

Practice address

26 Throckmorton LN
Floor 2
Old Bridge, NJ 08857-2520

Phone

(732) 952-5533

NPI assigned

Sep 2, 2015

Last updated

Sep 2, 2015By 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

Amit Poonia, MDNPI 1780904359

Title

Owner

Phone

(973) 473-4040

Specialties & licenses 1

Addresses

Tax ID family

Main Avenue Clifton Surgery Center LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Main Avenue Clifton Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Clifton, NJ
  • NPI 1134513260
  NPD tax ID

Practitioners 1

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.

• Amit Poonia, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Old Bridge, NJ
  • NPI 1780904359
  Authorized official Same address or phone

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

{
    "created_epoch": "1441152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441152000000",
    "number": "1720456130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1084 MAIN AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070112330",
            "telephone_number": "973-473-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 THROCKMORTON LN",
            "address_2": "FLOOR 2",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572520",
            "telephone_number": "732-952-5533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN AVENUE CLIFTON SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-02",
        "last_updated": "2015-09-02",
        "status": "A",
        "authorized_official_last_name": "POONIA",
        "authorized_official_first_name": "AMIT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-473-4040",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• M&S Supportive Care LLC
• Angela Dorota Maciag, PA-C
• Andrew T. Madaj, M.D.
• Alexandra Madrigal
• Khurram Mahmood
• Marisa Mak
• Grace P Malantic-Lu, M.D.
• Rami S Malek, DPM
• Aamir Malik, MD
• Jessica Salas Mann, MD

• Ambulatory Surgical Clinic/Center in Old Bridge, NJ
• Providers in Old Bridge, NJ by specialty
• Ambulatory Surgical Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; 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.