Provider Demographics
NPI:1588159719
Name:SURGISTAR HOLDINGS LLC
Entity type:Organization
Organization Name:SURGISTAR HOLDINGS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVARADO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:201-843-4444
Mailing Address - Street 1:289 MARKET ST
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:201-843-2606
Practice Address - Street 1:289 MARKET ST
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:201-843-2606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-29
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical