Organization
OUTPATIENT USA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY LIU (ADMINISTRATOR)
(973) 419-0200
Entity
Organization
Contact information
Practice address
475 PROSPECT AVENUE, SUITE 110, WEST ORANGE, NJ 07052
(973) 419-0200
(973) 419-0223
Mailing address
475 PROSPECT AVENUE, SUITE 110, WEST ORANGE, NJ 07052
(973) 419-0200
(973) 419-0223
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
—
—
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
10/17/2017
Last updated
10/17/2017
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