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General NPI Number Information
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NPI Number | 1285087106
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Entity Type | Organization
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Legal Business Name | BALA CYNWYD SURGERY CENTER
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Dates
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Enumeration Date | 07/15/2016
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Last Update Date | 07/15/2016
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Provider Practice Location Address
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Address Line | 100 PRESIDENTIAL BLVD FOURTH FLOOR
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City | BALA CYNWYD
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State | PA
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Zip | 19004-1108
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Country | US
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Telephone | 781-261-1860
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Fax | 781-610-9895
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Provider Business Mailing Address
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Address Line | 100 PRESIDENTIAL BLVD FOURTH FLOOR
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City | BALA CYNWYD
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State | PA
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Zip | 19004-1108
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Country | US
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Telephone | 781-261-1860
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Fax | 781-610-9895
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Authorized Official
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Title or Position | VICE PRESIDENT OF OPERATIONS
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Name | VICKI EDELMAN
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Credential |
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Telephone | 781-261-1860
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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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