Provider Demographics
NPI:1477142784
Name:UWS ASC LLC
Entity Type:Organization
Organization Name:UWS ASC LLC
Other - Org Name:UPPER WEST SIDE ENDOSCOPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:SEARLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:914-677-0200
Mailing Address - Street 1:230 W 74TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-2107
Mailing Address - Country:US
Mailing Address - Phone:914-677-0200
Mailing Address - Fax:
Practice Address - Street 1:230 W 74TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-2107
Practice Address - Country:US
Practice Address - Phone:203-894-2162
Practice Address - Fax:914-801-4664
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-12
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7002820ROtherSTATE LICENSE