Provider Demographics
NPI:1164723011
Name:SURGICAL SPECIALTY CENTER OF WESTCHESTER LLC
Entity Type:Organization
Organization Name:SURGICAL SPECIALTY CENTER OF WESTCHESTER LLC
Other - Org Name:PLASTIC SURGERY CENTER OF WESTCHESTER LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BERAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-777-8400
Mailing Address - Street 1:440 MAMARONECK AVE
Mailing Address - Street 2:SUITE 410
Mailing Address - City:HARRISON
Mailing Address - State:NY
Mailing Address - Zip Code:10528-2418
Mailing Address - Country:US
Mailing Address - Phone:914-777-8400
Mailing Address - Fax:914-777-8401
Practice Address - Street 1:440 MAMARONECK AVE
Practice Address - Street 2:SUITE 410
Practice Address - City:HARRISON
Practice Address - State:NY
Practice Address - Zip Code:10528-2418
Practice Address - Country:US
Practice Address - Phone:914-777-8400
Practice Address - Fax:914-777-8401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-09
Last Update Date:2014-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical