Organization
ENGLEWOOD SURGICAL ASSOCIATES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BARRY SUSSMAN MD (PARTNER)
(201) 894-0400
Entity
Organization
Contact information
Practice address
375 ENGLE ST, ENGLEWOOD, NJ 07631-1823
(201) 894-0400
Mailing address
375 ENGLE ST, ENGLEWOOD, NJ 07631-1823
(201) 894-0400
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
25MA03498600
NJ
2086S0129X
Vascular Surgery Physician
25MA03498600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8169403
—
NJ
01
—
CF1739
RRMEDICARE GROUP #
NJ
Enumeration date
05/31/2006
Last updated
04/09/2009
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