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Organization
PREMIER SURGICAL PAVILION, LLC
Active
Organization
PREMIER SURGICAL PAVILION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL EUGENE JONES M.D. (MEDICAL DIRECTOR)
(212) 223-0716
Entity
Organization
Contact information
Practice address
145 ROSEVILLE AVE, NEWARK, NJ 07107-1618
(201) 488-2101
(201) 488-3929
Mailing address
115 E 39TH ST, NEW YORK, NY 10016-0943
(212) 223-0716
(212) 223-0857
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
70781
NJ
Other
Enumeration date
02/13/2011
Last updated
05/11/2012
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