Healthcare Provider Details

I. General information

NPI: 1518046093
Provider Name (Legal Business Name): SURGICAL ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 04/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 RIVERSIDE DR SUITE 105
BINGHAMTON NY
13905-4176
US

IV. Provider business mailing address

161 RIVERSIDE DR SUITE 105
BINGHAMTON NY
13905-4176
US

V. Phone/Fax

Practice location:
  • Phone: 607-770-9471
  • Fax: 607-797-4699
Mailing address:
  • Phone: 607-770-9471
  • Fax: 607-797-4699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID CRAIG DREYFUSS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 607-770-9471