Provider Demographics
NPI:1124621743
Name:NORTH EAST REGIONAL SURGICAL CENTER, LLC
Entity type:Organization
Organization Name:NORTH EAST REGIONAL SURGICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:551-284-7220
Mailing Address - Street 1:633 FROM RD
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-3514
Mailing Address - Country:US
Mailing Address - Phone:551-284-7220
Mailing Address - Fax:551-284-7221
Practice Address - Street 1:650 FROM RD
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3517
Practice Address - Country:US
Practice Address - Phone:551-284-7220
Practice Address - Fax:551-284-7221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical