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General NPI Number Information
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NPI Number | 1295894848
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Entity Type | Organization
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Legal Business Name | THE SURGICAL CENTER OF EAST LIVERPOOL
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 16480 SAINT CLAIR AVE
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City | EAST LIVERPOOL
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State | OH
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Zip | 43920-9124
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Country | US
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Telephone | 330-386-9000
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Fax | 330-386-1255
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Provider Business Mailing Address
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Address Line | 16480 SAINT CLAIR AVE P.O. BOX 2640
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City | EAST LIVERPOOL
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State | OH
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Zip | 43920-9124
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Country | US
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Telephone | 330-386-9000
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Fax | 330-386-1255
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH P. SITARIK JR.
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Credential | D.O.
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Telephone | 330-386-9000
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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 | 114
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License Number State | OH
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