Provider Demographics
NPI:1194027920
Name:GRANT SURGICENTER LLC
Entity Type:Organization
Organization Name:GRANT SURGICENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:ZONSHAYN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-992-6000
Mailing Address - Street 1:2000 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-7287
Mailing Address - Country:US
Mailing Address - Phone:215-992-6000
Mailing Address - Fax:215-992-6001
Practice Address - Street 1:2000 GRANT AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-7287
Practice Address - Country:US
Practice Address - Phone:215-992-6000
Practice Address - Fax:215-992-6001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical