SHORE SURGICAL PAVILION, LLC – NPI #1154622579
Clinic/Center

SHORE SURGICAL PAVILION, LLC is an AHC clinic located in LAKEWOOD TOWNSHIP, NJ. NPPES has assigned the NPI number 1154622579 to SHORE SURGICAL PAVILION, LLC on November 17, 2010. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was previously updated about 7 years ago on Nov 19, 2019. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for SHORE SURGICAL PAVILION, LLC below.

NPI Profile for
SHORE SURGICAL PAVILION, LLC

NPI Number
1154622579
Enumeration Date

(more than 15 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
SHORE SURGICAL PAVILION, LLC
Primary location
475 ROUTE 70
SUITE 202
LAKEWOOD TOWNSHIP, NJ 08701-5897
Phone: (732) 730-3939 Fax: (732) 730-9119
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
DOUGLAS MANGANELLI
MEDICAL DIRECTOR
Phone: (732) 730-3939
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.