Healthcare Provider Details
I. General information
NPI: 1659194884
Provider Name (Legal Business Name): TODANI SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/06/2024
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
30 MAN MAR DR STE 6
PLAINVILLE MA
02762-2271
US
IV. Provider business mailing address
30 MAN MAR DR STE 6
PLAINVILLE MA
02762-2271
US
V. Phone/Fax
- Phone: 774-430-2020
- Fax:
- Phone: 774-430-2020
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QS0132X |
| Taxonomy | Ophthalmologic Surgery Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AMIT
TODANI
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 774-430-2020