Provider Demographics
NPI:1215080569
Name:SADDLE BROOK SURGICENTER INC
Entity type:Organization
Organization Name:SADDLE BROOK SURGICENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:SOLLITTO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:201-843-4444
Mailing Address - Street 1:289 MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663-6048
Mailing Address - Country:US
Mailing Address - Phone:201-843-4444
Mailing Address - Fax:201-368-2817
Practice Address - Street 1:289 MARKET STREET
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663-6048
Practice Address - Country:US
Practice Address - Phone:201-843-4444
Practice Address - Fax:201-368-2817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ23429261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
SA311037Medicare ID - Type Unspecified