Organization
LIBERTY AMBULATORY SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENETHA D MORAN (AUTHORIZED OFFICIAL)
(972) 763-3893
Entity
Organization
Contact information
Practice address
377 JERSEY AVE, SUITE 510, JERSEY CITY, NJ 07302-4393
(201) 878-3200
(201) 878-3201
Mailing address
377 JERSEY AVE, SUITE 510, JERSEY CITY, NJ 07302-4393
(201) 878-3200
(201) 878-3201
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
24440
NJ
Other
Enumeration date
05/27/2010
Last updated
02/05/2018
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