Healthcare Provider Details

I. General information

NPI: 1962306852
Provider Name (Legal Business Name): VALLEY OFFICE SURGICAL SUITE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2755 PHILMONT AVE STE 140
HUNTINGDON VALLEY PA
19006-5321
US

IV. Provider business mailing address

2755 PHILMONT AVE STE 140
HUNTINGDON VALLEY PA
19006-5321
US

V. Phone/Fax

Practice location:
  • Phone: 215-938-7878
  • Fax:
Mailing address:
  • Phone: 215-938-7878
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARY SIEGMAN
Title or Position: MEDICAL DIRECTOR
Credential:
Phone: 215-938-7878