Healthcare Provider Details
I. General information
NPI: 1750694832
Provider Name (Legal Business Name): SURGICARE ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/19/2010
Last Update Date: 08/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
760 NEWTOWN YARDLEY RD SUITE 115
NEWTOWN PA
18940-4500
US
IV. Provider business mailing address
4 FOXHALL RD
NEWTOWN PA
18940-2930
US
V. Phone/Fax
- Phone: 215-504-8900
- Fax: 215-504-8902
- Phone: 215-504-8900
- Fax: 215-504-8902
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 | |
VIII. Authorized Official
Name:
STEPHANIE
MOLDEN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 215-504-8900