Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Ambulatory Surgical |
261QA1903X | 49 | Ambulatory Surgical Center |
| NPI Number | 1124725312 |
| LBN Legal business name | 737 PARK AVENUE SURGICAL SUITES, LLC |
| Authorized official | JONATHAN GLASHOW - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 02/08/2023 |
| Last updated | 01/23/2025 - More than a year ago |
| Identifiers | n/a |
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