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General NPI Number Information
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NPI Number | 1417922808
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Entity Type | Organization
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Legal Business Name | CENTRAL QUEENS DAY SURGICAL CENTER, INC.
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 8340 WOODHAVEN BLVD
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City | GLENDALE
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State | NY
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Zip | 11385-7824
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Country | US
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Telephone | 718-849-8700
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Fax | 718-849-6523
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Provider Business Mailing Address
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Address Line | 8340 WOODHAVEN BLVD
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City | GLENDALE
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State | NY
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Zip | 11385-7824
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Country | US
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Telephone | 718-849-8700
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Fax | 718-849-6523
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. EMILY DOUKAS
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Credential |
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Telephone | 718-849-8700
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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 | 7003242R
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License Number State | NY
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