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General NPI Number Information
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NPI Number | 1548513674
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Entity Type | Organization
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Legal Business Name | AHGH FEMCARE OFFICE BASED SURGERY PC
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Dates
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Enumeration Date | 10/26/2012
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Last Update Date | 10/26/2012
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Provider Practice Location Address
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Address Line | 600 NORTHERN BLVD SUITE 109
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City | GREAT NECK
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State | NY
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Zip | 11021-5206
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Country | US
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Telephone | 516-482-6100
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Fax | 516-466-7616
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Provider Business Mailing Address
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Address Line | 600 NORTHERN BLVD SUITE 109
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City | GREAT NECK
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State | NY
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Zip | 11021-5206
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Country | US
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Telephone | 516-482-6100
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Fax | 516-466-7616
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. STEPHANIE C BUCK-HASKIN
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Credential | M.D.
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Telephone | 516-482-6100
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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 | 4615
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License Number State | NY
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