Provider Demographics
NPI:1558448837
Name:DOYLESTOWN SURGICAL CENTER LLC
Entity Type:Organization
Organization Name:DOYLESTOWN SURGICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:TENAGLIA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:215-918-5678
Mailing Address - Street 1:847 EASTON ROAD
Mailing Address - Street 2:SUITE 1400
Mailing Address - City:WARRINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:18976-2906
Mailing Address - Country:US
Mailing Address - Phone:215-918-5667
Mailing Address - Fax:215-918-5668
Practice Address - Street 1:847 EASTON ROAD
Practice Address - Street 2:SUITE 1400
Practice Address - City:WARRINGTON
Practice Address - State:PA
Practice Address - Zip Code:18976-2906
Practice Address - Country:US
Practice Address - Phone:215-918-5667
Practice Address - Fax:215-918-5668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1481150101261QA1903X
PA14811501261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA049569Medicare ID - Type Unspecified
04-9569Medicare UPIN