RENAISSANCE SURGERY CENTER LLC NPI 1174884530

NPI Information

  • NPI: 1174884530
  • Provider Name: RENAISSANCE SURGERY CENTER, LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • Doing Business As: INTERNATIONAL CENTER FOR MINIMALLY INVASIVE SPINE SURGERY, LLC
  • Address: 461 GOFFLE RD
    WYCKOFF, NJ
    ZIP 07481
  • Phone: (201) 857-0720

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NPI Details

RENAISSANCE SURGERY CENTER, LLC is an ambulatory surgical clinic center in Wyckoff, NJ. RENAISSANCE SURGERY CENTER, LLC NPI is 1174884530. The provider is registered as an organization entity type.
The provider Is Doing Business As International Center For Minimally Invasive Spine Surgery, Llc.

The provider's business location address is:

461 GOFFLE RD
WYCKOFF, NJ
ZIP 07481-003
Phone: (201) 857-0720
Fax: (201) 857-0948

The provider's authorized official is Louis G Quartararo .
The authorized official title is Managing Partner and has the following contact phone number (201) 857-0720.

The enumeration date for this NPI number is 6/1/2012 and was last updated on 2/15/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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
1261QA1903XClinic/CenterAmbulatory SurgicalYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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