Healthcare Provider Details

I. General information

NPI: 1750696134
Provider Name (Legal Business Name): RMA OF PHILADELPHIA SURGICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2010
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 E SNEDESFORD ROAD
WAYNE PA
19087
US

IV. Provider business mailing address

140 ALLEN ROAD
BASKING RIDGE NJ
07920
US

V. Phone/Fax

Practice location:
  • Phone: 215-654-1544
  • Fax: 215-654-1544
Mailing address:
  • Phone: 866-762-3140
  • Fax: 973-290-8370

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: REBECCA JENCO
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 973-656-2840