Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Ambulatory Surgical |
261QA1903X | 49 | Ambulatory Surgical Center |
| NPI Number | 1083962948 |
| LBN Legal business name | ADVANCED AMBULATORY ENDOSCOPY PLLC |
| Authorized official | TIMOTHY WONG - (SOLE MEMBER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 08/27/2012 |
| Last updated | 09/10/2012 - About 14 years ago |
| Identifiers | n/a |
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