# MODERN MEDICINE SURGICAL CENTER, LLC

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

## Provider details

- **NPI number:** 1780217034
- **Authorized official:** CIRO RANDAZZO MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (551) 284-7220

## Contact information

- **Practice address:** 633 FROM RD, PARAMUS, NJ 07652-3514
- **Practice address phone:** (551) 284-7220
- **Practice address fax:** (551) 284-7221
- **Mailing address:** 633 FROM RD, PARAMUS, NJ 07652-3514
- **Mailing address phone:** (551) 284-7220
- **Mailing address fax:** (551) 284-7221

## Taxonomy

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

## Other

- **Enumeration date:** 02/14/2020
- **Last updated:** 02/14/2020