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Organization

BOLANOWSKI SURGICAL GROUP PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PAUL JP BOLANOWSKI MD (PRESIDENT)
(908) 352-8110
Entity
Organization

Contact information

Practice address
219 S BROAD ST, ELIZABETH, NJ 07202-3453
(908) 352-8110
(908) 355-9583
Mailing address
219 S BROAD ST, ELIZABETH, NJ 07202-3453
(908) 352-8110
(908) 355-9583

Taxonomy

Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
MA25753
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1553003
NJ
Enumeration date
02/22/2007
Last updated
08/22/2020
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