Healthcare Provider Details

I. General information

NPI: 1225133994
Provider Name (Legal Business Name): VALLEY AMBULATORY SURGICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 DRIFT COURT
BETHLEHEM PA
18020
US

IV. Provider business mailing address

201 DRIFT COURT
BETHLEHEM PA
18020
US

V. Phone/Fax

Practice location:
  • Phone: 610-882-9111
  • Fax: 610-882-9946
Mailing address:
  • Phone: 610-882-9111
  • Fax: 610-882-9946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ANTHONY D. DIPPOLITO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 610-882-9111