Provider Demographics
NPI:1730301284
Name:PHYSICIANS CHOICE SURGICENTER INC
Entity Type:Organization
Organization Name:PHYSICIANS CHOICE SURGICENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MAYER
Authorized Official - Middle Name:J
Authorized Official - Last Name:SAAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-322-9800
Mailing Address - Street 1:82-12 151 AVENUE SUITE #12
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414
Mailing Address - Country:US
Mailing Address - Phone:718-322-9800
Mailing Address - Fax:718-323-7598
Practice Address - Street 1:82-12 151 AVENUE SUITE #12
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414
Practice Address - Country:US
Practice Address - Phone:718-322-9800
Practice Address - Fax:718-323-7598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7003253R261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04649Medicare PIN