Shore Surgical Pavilion, LLC
NPI #1154622579 in Lakewood, New Jersey
Provider Information
- NPI Number
- 1154622579
- Entity Type
- Organization
- Organization Name
- Shore Surgical Pavilion, LLC
- Primary Specialty
- Clinic/Center - Ambulatory Surgical
- Enumeration Date
- Nov 17, 2010
- Last Updated
- Nov 19, 2019
Practice Location
- Address
- 475 ROUTE 70
- Address 2
- SUITE 202
- City
- Lakewood
- State
- New Jersey
- ZIP Code
- 08701-5897
- Phone
- (732) 730-3939
Authorized Official
- Name
- MR. DOUGLAS MANGANELLI, M.D.
- Title
- MEDICAL DIRECTOR
- Phone
- (732) 730-3939
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Ambulatory Surgical — Ambulatory Surgical |
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