Provider Demographics
NPI:1053566513
Name:NORTHEAST SURGICARE, LLC
Entity type:Organization
Organization Name:NORTHEAST SURGICARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIMITRIOS
Authorized Official - Middle Name:CHRISTOS
Authorized Official - Last Name:LAMBROU
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-714-0070
Mailing Address - Street 1:475 ROUTE 70 STE 203
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5897
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:475 ROUTE 70 STE 203
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5897
Practice Address - Country:US
Practice Address - Phone:732-714-0070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-25
Last Update Date:2017-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical