Heritage General And Colorectal Surgery, PA
Surgery in Teaneck, NJ. Organization (NPI-2).
NPI number1912459348
StatusActive
Last updated in NPPESNov 2, 2016
Details
- NPI
- 1912459348
- Entity type
- Organization (NPI-2)
- Legal business name
- Heritage General And Colorectal Surgery, PA
- Organization subpart
- No
- Enumeration date
- Nov 2, 2016
- Last updated
- Nov 2, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208600000X | Surgery | – | – | Yes |
| 208C00000X | Colon & Rectal Surgery | – | – |
Practice location
741 Teaneck RdSuite B
Teaneck, NJ 07666-4243
Phone 201-833-2888
Mailing address
741 Teaneck RdSuite B
Teaneck, NJ 07666-4243
Phone 201-833-2888
Authorized official
Farshad Mansouri
President
7165237930
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