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General NPI Number Information
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NPI Number | 1861462038
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Entity Type | Organization
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Legal Business Name | AESTIQUE AMBULATORY SURGICAL CENTER, INC
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 03/23/2016
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Provider Practice Location Address
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Address Line | 1 AESTHETIC WAY
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City | GREENSBURG
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State | PA
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Zip | 15601-9500
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Country | US
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Telephone | 724-832-7555
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Fax | 724-832-7566
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Provider Business Mailing Address
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Address Line | 1 AESTHETIC WAY
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City | GREENSBURG
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State | PA
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Zip | 15601-9500
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Country | US
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Telephone | 724-832-7555
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Fax | 724-832-7566
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Authorized Official
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Title or Position | CFO
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Name | MARIA SOOHEY
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Credential |
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Telephone | 724-832-7555
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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 | 01611500
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License Number State | PA
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