Provider Demographics
NPI:1386934610
Name:PEDIATRIC SURGICAL ASSOCIATES,P.A.
Entity type:Organization
Organization Name:PEDIATRIC SURGICAL ASSOCIATES,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJINDER
Authorized Official - Middle Name:P
Authorized Official - Last Name:GANDHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-225-9440
Mailing Address - Street 1:30 W CENTURY RD
Mailing Address - Street 2:#235
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1433
Mailing Address - Country:US
Mailing Address - Phone:201-225-9440
Mailing Address - Fax:201-225-9430
Practice Address - Street 1:30 W CENTURY RD
Practice Address - Street 2:#235
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1433
Practice Address - Country:US
Practice Address - Phone:201-225-9440
Practice Address - Fax:201-225-9430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-07
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA036957174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty