Organization · NPI-2

Bergen Surgical Oncology, PA

Surgery, Surgical Oncology · Paramus, NJ

NPI number1083876171
StatusActive
Last updated in NPPESFeb 23, 2010

Details

NPI
1083876171
Entity type
Organization (NPI-2)
Legal business name
Bergen Surgical Oncology, PA
Organization subpart
No
Enumeration date
Jun 30, 2008
Last updated
Feb 23, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2086X0206X Surgery, Surgical Oncology25MA05981200NJYes

Practice location

1 Valley Health Plz
Paramus, NJ 07652-3628

Phone 201-634-5438 · Fax 201-634-5352

Mailing address

1 Valley Health Plz
Paramus, NJ 07652-3628

Phone 201-634-5438 · Fax 201-634-5352

Authorized official

Anusak Yiengpruksawan
President
2016345438

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