VANGUARD SURGICAL CENTER, LLC. - NPI NUMBER 1023350907

Summary

Provider Name: VANGUARD SURGICAL CENTER, LLC.

NPI Number: 1023350907

Clasification: Clinic/Center (261QA1903X)

Specialization: Ambulatory Surgical

Address:
113 ESSEX ST
MAYWOOD, NJ
ZIP 07607

Phone Number: (201) 251-7725



Detailed Information

VANGUARD SURGICAL CENTER, LLC. is an ambulatory surgical clinic/center in Maywood, NJ. The assigned NPI number for this provider is 1023350907 and is registered as an organization entity type.

The provider's business address is:

113 ESSEX ST
MAYWOOD, NJ
ZIP 07607-020
Phone: (201) 251-7725

The provider's authorized official is Dante A Implicito .
The authorized official title is Managing Member and has the following contact phone number (201) 251-7725.

The enumeration date for this NPI number is 3/19/2013 and was last updated on 8/20/2013.

Map - Location of Practice

Similar Providers

NPI Provider Name / Taxonomy
1184900102 METROPOLITAN NEW JERSEY, LLC
Clinic/Center (Ambulatory Surgical)
1003084385 AMERICAN CURRENT CARE OF NEW JERSEY PA
Clinic/Center (Urgent Care)
1235192675 HACKENSACK ENDOSCOPY CENTER, LLC
Clinic/Center (Ambulatory Surgical)
1053597096 MY HOME ADULT DAY CARE CENTER
Clinic/Center (Adult Day Care)
1023162385 PROSPECT WOMEN'S HEALTH CENTER, LLC
Clinic/Center (Health Service)
1124270608 CONCENTRA HEALTH SERVICES, INC.
Clinic/Center (Health Service)
1013184894 URGENT MEDICAL CARE@HACKENSACK
Clinic/Center (Urgent Care)





Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 261QA1903X Clinic/Center Ambulatory Surgical Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1023350907 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name VANGUARD SURGICAL CENTER, LLC. The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider First Line Business Practice Location Address 113 ESSEX ST The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
6 Provider Business Practice Location Address City Name MAYWOOD The city name in the location address of the provider being identified.
7 Provider Business Practice Location Address State Name NJ The State code in the location of the provider being identified.
8 Provider Business Practice Location Address Postal Code 076071020 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
9 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
10 Provider Business Practice Location Address Telephone Number 2012517725 The telephone number associated with the location address of the provider being identified.
11 Provider Enumeration Date 3/19/2013 The date the provider was assigned a unique identifier (assigned an NPI).
12 Last Update Date 8/20/2013 The date that a record was last updated or changed.
13 Authorized Official Last Name IMPLICITO The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
14 Authorized Official First Name DANTE The first name of the authorized official.
15 Authorized Official Middle Name A The middle name of the authorized official.
16 Authorized Official Title or Position MANAGING MEMBER The title or position of the authorized official.
17 Authorized Official Telephone Number 2012517725 The 10-position telephone number of the authorized official.
18 Healthcare Provider Taxonomy Code 1 261QA1903X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
19 Healthcare Provider Primary Taxonomy Switch 1 Y
20 Is Organization Subpart N
21 Authorized Official Name Prefix Text DR.
22 Authorized Official Credential Text M.D.

Download Record

Download this NPI record in Text format: Export

Download this NPI record in Excel (CSV) format: Export

Download this NPI record in XML format: Export




This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.