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General NPI Number Information
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NPI Number | 1184499196
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Entity Type | Organization
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Legal Business Name | PERFORMANCE SURGICAL CENTER LLC
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Dates
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Enumeration Date | 11/20/2023
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Last Update Date | 03/27/2024
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Provider Practice Location Address
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Address Line | 1408 OCEAN AVE FL 1
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City | BROOKLYN
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State | NY
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Zip | 11230-3814
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Country | US
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Telephone | 718-725-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 2050 LAKEVILLE RD
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-1639
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Country | US
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Telephone | 718-725-8900
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER AND PRINCIP
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Name | SANDRO STARNA
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Credential |
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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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