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General NPI Number Information
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NPI Number | 1063308096
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Entity Type | Organization
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Legal Business Name | CHRISTIANA CARE HAVERTOWN ASC, LLC
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Dates
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Enumeration Date | 06/16/2025
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 2010 W CHESTER PIKE STE 212
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City | HAVERTOWN
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State | PA
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Zip | 19083-2736
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Country | US
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Telephone | 610-853-7700
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Fax |
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Provider Business Mailing Address
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Address Line | 2010 W CHESTER PIKE STE 212
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City | HAVERTOWN
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State | PA
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Zip | 19083-2736
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/OFFICER
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Name | DOUGLAS AZAR
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Credential |
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Telephone | 484-678-8475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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