# RENAISSANCE SURGERY CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** International Center for Minimally Invasive Spine Surgery, LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174884530
- **Authorized official:** MR. LOUIS G QUARTARARO MD (MANAGING PARTNER)
- **Authorized official phone:** (201) 857-0720

## Contact information

- **Practice address:** 461 GOFFLE RD, WYCKOFF, NJ 07481-3003
- **Practice address phone:** (201) 857-0720
- **Practice address fax:** (201) 857-0948
- **Mailing address:** 461 GOFFLE RD, WYCKOFF, NJ 07481-3003
- **Mailing address phone:** (201) 857-0720
- **Mailing address fax:** (201) 857-0948

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/01/2012
- **Last updated:** 02/15/2017