Provider Demographics
NPI:1578548467
Name:SURGICAL ASSOCIATES OF NEW CASTLE, PA
Entity Type:Organization
Organization Name:SURGICAL ASSOCIATES OF NEW CASTLE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SEYEDMEHDI
Authorized Official - Middle Name:
Authorized Official - Last Name:JADALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-737-4990
Mailing Address - Street 1:324 E MAIN ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19711-7150
Mailing Address - Country:US
Mailing Address - Phone:302-737-4990
Mailing Address - Fax:302-737-5082
Practice Address - Street 1:324 E MAIN ST
Practice Address - Street 2:SUITE 204
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19711-7150
Practice Address - Country:US
Practice Address - Phone:302-737-4990
Practice Address - Fax:302-737-5082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-13
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000076302Medicaid
073747Medicare ID - Type UnspecifiedGROUP #