Provider Demographics
NPI:1659338382
Name:STERLING SURGICAL CENTER, LLC
Entity Type:Organization
Organization Name:STERLING SURGICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:DIAZ-ORDAZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-712-0600
Mailing Address - Street 1:303 STERLING DRIVE
Mailing Address - Street 2:
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-1571
Mailing Address - Country:US
Mailing Address - Phone:716-712-0600
Mailing Address - Fax:716-712-0601
Practice Address - Street 1:303 STERLING DRIVE
Practice Address - Street 2:
Practice Address - City:ORCHARD PARK
Practice Address - State:NY
Practice Address - Zip Code:14127-1571
Practice Address - Country:US
Practice Address - Phone:716-712-0600
Practice Address - Fax:716-712-0601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1435203R261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000000464OtherHEALTH NOW NEW YORK
NY02291349Medicaid
NY6YOtherINDEPENDENT HEALTH
NY02291349Medicaid
NYDD1587Medicare UPIN