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General NPI Number Information
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NPI Number | 1891784955
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Entity Type | Organization
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Legal Business Name | PLATTSBURGH ASC LLC
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Dates
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Enumeration Date | 10/20/2005
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Last Update Date | 07/05/2010
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Provider Practice Location Address
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Address Line | 450 MARGARET ST
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City | PLATTSBURGH
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State | NY
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Zip | 12901-1755
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Country | US
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Telephone | 518-561-3144
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Fax | 518-561-3155
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Provider Business Mailing Address
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Address Line | 450 MARGARET ST
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City | PLATTSBURGH
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State | NY
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Zip | 12901-1755
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Country | US
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Telephone | 518-561-3144
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Fax | 518-561-3155
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. KJELL DAHLEN
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Credential | MD
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Telephone | 518-561-3144
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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 |
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License Number State |
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