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Organization
LASER SURGERY NEW JERSEY
Active
Organization
LASER SURGERY NEW JERSEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELANIE GROSS (DIRECTOR OF REVENUE CYCLE)
(214) 615-5168
Entity
Organization
Contact information
Practice address
111 WANAQUE AVE, POMPTON LAKES, NJ 07442-2101
(214) 615-5168
(888) 526-9542
Mailing address
PO BOX 3837, CAROL STREAM, IL 60132-3837
(214) 615-5168
(888) 526-9542
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
2MA07838400
NJ
Other
Enumeration date
07/30/2012
Last updated
07/30/2012
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