Provider Demographics
NPI:1811299530
Name:KOCSIS SURGICAL SERVICES LLC
Entity type:Organization
Organization Name:KOCSIS SURGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-453-7200
Mailing Address - Street 1:1451 ROUTE 34
Mailing Address - Street 2:SUITE 304
Mailing Address - City:WALL TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:07727-1612
Mailing Address - Country:US
Mailing Address - Phone:732-453-7200
Mailing Address - Fax:732-453-7277
Practice Address - Street 1:1451 ROUTE 34
Practice Address - Street 2:SUITE 304
Practice Address - City:WALL TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07727-1612
Practice Address - Country:US
Practice Address - Phone:732-453-7200
Practice Address - Fax:732-453-7277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-01
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05156400208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty