Provider Demographics
NPI:1043811599
Name:FREEDOM SURGICAL CENTER, LLC
Entity type:Organization
Organization Name:FREEDOM SURGICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:R
Authorized Official - Last Name:GIGANTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-478-9160
Mailing Address - Street 1:1455 BROAD ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07003-3039
Mailing Address - Country:US
Mailing Address - Phone:201-478-9160
Mailing Address - Fax:
Practice Address - Street 1:1455 BROAD ST STE 100
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-3039
Practice Address - Country:US
Practice Address - Phone:201-478-9160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-02
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical