Provider Demographics
NPI:1689998841
Name:NORTH JERSEY LAPAROSCOPIC ASSOCIATES
Entity type:Organization
Organization Name:NORTH JERSEY LAPAROSCOPIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEFANIE
Authorized Official - Middle Name:SARA
Authorized Official - Last Name:VAIMAKIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-227-9444
Mailing Address - Street 1:309 ENGLE STREET
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631
Mailing Address - Country:US
Mailing Address - Phone:201-227-9444
Mailing Address - Fax:201-227-8326
Practice Address - Street 1:309 ENGLE STREET
Practice Address - Street 2:SUITE 1
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631
Practice Address - Country:US
Practice Address - Phone:201-227-9444
Practice Address - Fax:201-227-8326
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-17
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100387300103TC0700X
NJ25MAO7456100208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty