# LIBERTY AMBULATORY SURGERY CENTER, LLC

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

## Provider details

- **NPI number:** 1518286681
- **Authorized official:** JENETHA D MORAN (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (972) 763-3893

## Contact information

- **Practice address:** 377 JERSEY AVE, SUITE 510, JERSEY CITY, NJ 07302-4393
- **Practice address phone:** (201) 878-3200
- **Practice address fax:** (201) 878-3201
- **Mailing address:** 377 JERSEY AVE, SUITE 510, JERSEY CITY, NJ 07302-4393
- **Mailing address phone:** (201) 878-3200
- **Mailing address fax:** (201) 878-3201

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 24440 | NJ | Yes |

## Other

- **Enumeration date:** 05/27/2010
- **Last updated:** 02/05/2018