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Organization

HERITAGE GENERAL AND COLORECTAL SURGERY, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. FARSHAD MANSOURI (PRESIDENT)
(716) 523-7930
Entity
Organization

Contact information

Practice address
741 TEANECK RD, SUITE B, TEANECK, NJ 07666-4243
(201) 833-2888
Mailing address
741 TEANECK RD, SUITE B, TEANECK, NJ 07666-4243
(201) 833-2888

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
208C00000X
Colon & Rectal Surgery Physician

Other

Enumeration date
11/02/2016
Last updated
11/02/2016
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