Provider Demographics
NPI:1215989025
Name:SURGICAL ASSOCIATES OF SUSSEX COUNTY PA
Entity type:Organization
Organization Name:SURGICAL ASSOCIATES OF SUSSEX COUNTY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-383-6244
Mailing Address - Street 1:135 NEWTON SPARTA RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07860-2795
Mailing Address - Country:US
Mailing Address - Phone:973-383-6244
Mailing Address - Fax:973-383-0573
Practice Address - Street 1:135 NEWTON SPARTA RD
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:NJ
Practice Address - Zip Code:07860-2795
Practice Address - Country:US
Practice Address - Phone:973-383-6244
Practice Address - Fax:973-383-0573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3450708Medicaid
NJ3450708Medicaid