Organization
LIBERTY SURGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HELEN M KENNEDY (CORPORATE DIRECTOR, PHYSICIAN SERVI)
(201) 521-5934
Entity
Organization
Contact information
Practice address
377 JERSEY AVENUE, SUITE 220, JERSEY CITY, NJ 07302-4396
(201) 309-2380
(201) 309-2381
Mailing address
355 GRAND STREET, JERSEY CITY, NJ 07302-4321
(201) 915-2450
(201) 915-2192
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0127X
Trauma Surgery Physician
—
—
208C00000X
Colon & Rectal Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6603700
—
NJ
Enumeration date
07/07/2006
Last updated
01/27/2012
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