Provider Demographics
NPI:1396230777
Name:LUXURGERY 880
Entity Type:Organization
Organization Name:LUXURGERY 880
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACILITY DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SACHIN
Authorized Official - Middle Name:MAHAVIR
Authorized Official - Last Name:SHRIDHARANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-508-0000
Mailing Address - Street 1:880 FIFTH AVENUE
Mailing Address - Street 2:#1B/C/D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021
Mailing Address - Country:US
Mailing Address - Phone:212-508-0000
Mailing Address - Fax:212-508-0005
Practice Address - Street 1:880 FIFTH AVENUE
Practice Address - Street 2:#1B/C/D
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-508-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-27
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical