Provider Demographics
NPI:1508920521
Name:NEW YORK INSTITUTE OF SAME DAY SURGERY
Entity Type:Organization
Organization Name:NEW YORK INSTITUTE OF SAME DAY SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DELEGATED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:AYMAN
Authorized Official - Middle Name:Z
Authorized Official - Last Name:MATTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-359-9000
Mailing Address - Street 1:99 DUTCH HILL RD
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:NY
Mailing Address - Zip Code:10962-2106
Mailing Address - Country:US
Mailing Address - Phone:845-359-9000
Mailing Address - Fax:845-359-0729
Practice Address - Street 1:99 DUTCH HILL RD
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:NY
Practice Address - Zip Code:10962-2106
Practice Address - Country:US
Practice Address - Phone:845-359-9000
Practice Address - Fax:845-359-0729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY215965-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYIC0716OtherHEALTHNET #
NY0051708OtherAETNA HMO#
NYA448704OtherOXFORD#
NY003621OtherEMPIRE BCBS#
NY01241923Medicaid
NY8457010OtherAETNA PPO#
NY0051708OtherAETNA HMO#
NYZ95061Medicare PIN