Provider Demographics
NPI:1417911470
Name:SURGICAL ASSOCIATES OF WINDBER
Entity Type:Organization
Organization Name:SURGICAL ASSOCIATES OF WINDBER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RODOLFO
Authorized Official - Middle Name:LAZO
Authorized Official - Last Name:FURIGAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-467-5513
Mailing Address - Street 1:609 SOMERSET AVE
Mailing Address - Street 2:
Mailing Address - City:WINDBER
Mailing Address - State:PA
Mailing Address - Zip Code:15963-1330
Mailing Address - Country:US
Mailing Address - Phone:814-467-5513
Mailing Address - Fax:814-467-8455
Practice Address - Street 1:609 SOMERSET AVE
Practice Address - Street 2:
Practice Address - City:WINDBER
Practice Address - State:PA
Practice Address - Zip Code:15963-1330
Practice Address - Country:US
Practice Address - Phone:814-467-5513
Practice Address - Fax:814-467-8455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-14
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031178L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0055808OtherUNITED MINE WORKERS OF AM
PA0006591720002Medicaid
PA0006591720002Medicaid