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General NPI Number Information
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NPI Number | 1508804527
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Entity Type | Organization
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Legal Business Name | HIGHLANDS SURGICAL ASSOCIATION
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Dates
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Enumeration Date | 06/03/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1629 UNION AVE
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City | NATRONA HEIGHTS
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State | PA
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Zip | 15065-2134
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Country | US
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Telephone | 724-224-4600
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Fax | 724-224-2775
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Provider Business Mailing Address
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Address Line | 1629 UNION AVE
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City | NATRONA HEIGHTS
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State | PA
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Zip | 15065-2134
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Country | US
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Telephone | 724-224-4600
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Fax | 724-224-2775
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Authorized Official
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Title or Position | BILLING
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Name | NICOLE LARKO
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Credential |
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Telephone | 724-224-4600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MD020593E
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License Number State | PA
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