Provider Demographics
NPI:1578151973
Name:METRO CT SURGICAL PC
Entity Type:Organization
Organization Name:METRO CT SURGICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:WOO NOVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-483-0934
Mailing Address - Street 1:39 VESTRY ST APT 1A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-1767
Mailing Address - Country:US
Mailing Address - Phone:917-363-5454
Mailing Address - Fax:866-391-1540
Practice Address - Street 1:2365 BOSTON POST RD STE 103
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-3554
Practice Address - Country:US
Practice Address - Phone:646-483-0934
Practice Address - Fax:866-391-1540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-02
Last Update Date:2021-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty