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Organization

RIDGEWOOD AMBULATORY SURGERY CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOEL EDWARD KOPELMAN MD (PRESIDENT)
(201) 444-9002
Entity
Organization

Contact information

Practice address
1200 E RIDGEWOOD AVE, RIDGEWOOD, NJ 07450-3957
(201) 444-9002
(201) 612-8114
Mailing address
1200 E RIDGEWOOD AVE, RIDGEWOOD, NJ 07450-3957
(201) 444-9002
(201) 612-8114

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
490002689
RAILROAD MEDICARE
NJ
01
A1011061
OXFORD
NJ
01
Z03891
HEALTHNET
NJ
Enumeration date
03/16/2006
Last updated
09/20/2012
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