# GLEN RIDGE SURGI CENTER

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

## Provider details

- **NPI number:** 1972556900
- **Authorized official:** RV BALLEM MD (PRESIDENT)
- **Authorized official phone:** (973) 783-2626

## Contact information

- **Practice address:** 230 SHERMAN AVE, GLEN RIDGE, NJ 07028-1529
- **Practice address phone:** (973) 783-2626
- **Mailing address:** 230 SHERMAN AVE, GLEN RIDGE, NJ 07028-1529

## Taxonomy

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

## Other

- **Enumeration date:** 05/19/2006
- **Last updated:** 08/22/2020