# PENINSULA SURGERY CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1255636213
- **Authorized official:** MR. DENNIS I. KELLY (CONTRACTED MANAGER)
- **Authorized official phone:** (201) 620-3636

## Contact information

- **Practice address:** 29 E 29TH ST, BAYONNE, NJ 07002-4654
- **Practice address phone:** (973) 729-3276
- **Mailing address:** 29 E 29TH ST, BAYONNE, NJ 07002-4654

## Taxonomy

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

## Other

- **Enumeration date:** 01/21/2011
- **Last updated:** 04/26/2013