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General NPI Number Information
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NPI Number | 1104068485
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Entity Type | Organization
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Legal Business Name | MILLENNIUM AMBULATORY SURGERY CENTER, LLC
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Dates
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Enumeration Date | 04/01/2009
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Last Update Date | 07/01/2011
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Provider Practice Location Address
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Address Line | 1408 OCEAN AVENUE 1ST FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11230
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Country | US
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Telephone | 718-725-8900
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Fax | 718-876-0343
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Provider Business Mailing Address
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Address Line | 1408 OCEAN AVENUE 1ST FLOOR
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City | BROOKLYN
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State | NY
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Zip | 11230
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Country | US
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Telephone | 718-725-8900
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Fax | 718-876-0343
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. MICHAEL ASH
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Credential | CST, FA
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Telephone | 718-725-8900
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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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