# NJ INSTITUTE OF MINIMAL INVASIVE SURGERY LLC

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

## Provider details

- **NPI number:** 1801287198
- **Authorized official:** PEYMAN MAGHSOUDLOU (MANAGER)
- **Authorized official phone:** (973) 773-2039

## Contact information

- **Practice address:** 716 BROAD ST, CLIFTON, NJ 07013-1645
- **Practice address phone:** (973) 773-2039
- **Mailing address:** PO BOX 2130, WEST PATERSON, NJ 07424-7130
- **Mailing address phone:** (973) 773-2039

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/09/2015
- **Last updated:** 02/09/2015