# LASER SURGERY NEW JERSEY

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

## Provider details

- **NPI number:** 1841546702
- **Authorized official:** MS. MELANIE GROSS (DIRECTOR OF REVENUE CYCLE)
- **Authorized official phone:** (214) 615-5168

## Contact information

- **Practice address:** 111 WANAQUE AVE, POMPTON LAKES, NJ 07442-2101
- **Practice address phone:** (214) 615-5168
- **Practice address fax:** (888) 526-9542
- **Mailing address:** PO BOX 3837, CAROL STREAM, IL 60132-3837
- **Mailing address phone:** (214) 615-5168
- **Mailing address fax:** (888) 526-9542

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 2MA07838400 | NJ | Yes |

## Other

- **Enumeration date:** 07/30/2012
- **Last updated:** 07/30/2012