# TDG SURGERY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** THE DERMATOLOGY GROUP
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1245585256
- **Legal business name:** THE DERMATOLOGY GROUP
- **Authorized official:** ANGELA SHORT (VICE PRESIDENT)
- **Authorized official phone:** (973) 571-2121

## Contact information

- **Practice address:** 140 N RTE 17, SUITE 105, PARAMUS, NJ 07652-2809
- **Practice address phone:** (973) 571-2121
- **Mailing address:** 140 N RTE 17, SUITE 105, PARAMUS, NJ 07652-2809
- **Mailing address phone:** (973) 571-2121

## Taxonomy

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

## Other

- **Enumeration date:** 07/16/2012
- **Last updated:** 10/10/2012