Healthcare Provider Details

I. General information

NPI: 1326117185
Provider Name (Legal Business Name): CHILDREN'S SURGICAL ASSOCIATES LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 CIVIC CENTER BLVD
PHILADELPHIA PA
19104-4395
US

IV. Provider business mailing address

3401 CIVIC CENTER BLVD
PHILADELPHIA PA
19104-4319
US

V. Phone/Fax

Practice location:
  • Phone: 215-590-2208
  • Fax: 267-425-9552
Mailing address:
  • Phone: 267-425-9538
  • Fax: 267-425-9552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. LINDA C FLOCCO
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 215-590-2700