Organization
COUNTY LINE ENDOSCOPY & SURGICAL CENTER LLC
Active
Other names
County Line ASC
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA P LUGO (OFFICE MGR)
(201) 295-0900
Entity
Organization
Contact information
Practice address
9226 KENNEDY BLVD, UNIT A, NORTH BERGEN, NJ 07047
(201) 295-0900
(201) 869-9501
Mailing address
9226 KENNEDY BLVD, UNIT A, NORTH BERGEN, NJ 07047
(201) 295-0900
(201) 869-9501
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
311175
HORIZON BCBS
NJ
Enumeration date
11/09/2006
Last updated
05/13/2008
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