NPI 1013016765

Southern Ocean County Surgical Association, LLC

Organisation Surgery Physician Manahawkin, NJ

Practice location

Address: 44 Nautilus Dr Suite 2b, Manahawkin, NJ 08050-2466
Phone: (609) 597-9477
Fax: (609) 489-0226

Authorised official

Name: Sergey Grachev
Title: Proprietor
Phone: (609) 597-9477

Registered specialties

Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208600000X Licence 25MA07937200 (NJ)

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Registry record

NPI: 1013016765
Entity type: Organization
NPI issued: 21 Sep 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.