Provider Demographics
NPI:1699475368
Name:PALISADES SURGICAL SUITES, LLC
Entity type:Organization
Organization Name:PALISADES SURGICAL SUITES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCSHERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-275-7799
Mailing Address - Street 1:1 BRIDGE PLZ N STE 540
Mailing Address - Street 2:
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-7530
Mailing Address - Country:US
Mailing Address - Phone:551-465-5595
Mailing Address - Fax:551-465-5592
Practice Address - Street 1:1 BRIDGE PLZ N STE 540
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-7101
Practice Address - Country:US
Practice Address - Phone:804-651-5216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical