# ASC OF NEW JERSEY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** AMBULATORY SURGICAL CENTER OF NEW JERSEY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629612437
- **Authorized official:** JENETHA MORAN (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (972) 763-3893

## Contact information

- **Practice address:** 5 PROGRESS ST STE 2, EDISON, NJ 08820-1102
- **Practice address phone:** (908) 755-9671
- **Mailing address:** 15305 DALLAS PKWY STE 1600, ADDISON, TX 75001-6491
- **Mailing address phone:** (972) 763-3893
- **Mailing address fax:** (972) 692-6745

## Taxonomy

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

## Other

- **Enumeration date:** 11/05/2019
- **Last updated:** 11/05/2019