Provider Demographics
NPI:1659653004
Name:UPPER EAST SIDE SURGICAL SUITE
Entity Type:Organization
Organization Name:UPPER EAST SIDE SURGICAL SUITE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-988-1800
Mailing Address - Street 1:35 E 84TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0871
Mailing Address - Country:US
Mailing Address - Phone:212-988-1800
Mailing Address - Fax:212-988-3700
Practice Address - Street 1:35 E 84TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0871
Practice Address - Country:US
Practice Address - Phone:212-988-1800
Practice Address - Fax:212-988-3700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical