Provider Demographics
NPI:1972933851
Name:ENGLEWOOD LAPAROSCOPIC & BARIATRIC ASSOCIATES, LLC
Entity type:Organization
Organization Name:ENGLEWOOD LAPAROSCOPIC & BARIATRIC ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:VAIMAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-227-9444
Mailing Address - Street 1:309 ENGLE ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-1824
Mailing Address - Country:US
Mailing Address - Phone:201-227-9444
Mailing Address - Fax:201-227-8326
Practice Address - Street 1:309 ENGLE ST
Practice Address - Street 2:SUITE 1
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-1824
Practice Address - Country:US
Practice Address - Phone:201-227-9444
Practice Address - Fax:201-227-8326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty