Provider Demographics
NPI:1780835991
Name:GREENWICH AMBULATORY SURGERY CENTER LLC
Entity Type:Organization
Organization Name:GREENWICH AMBULATORY SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROSENQUEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-833-2375
Mailing Address - Street 1:PO BOX 181
Mailing Address - Street 2:
Mailing Address - City:CROTON FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:10519-0181
Mailing Address - Country:US
Mailing Address - Phone:860-833-2375
Mailing Address - Fax:
Practice Address - Street 1:55 HOLLY HILL LN
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-6074
Practice Address - Country:US
Practice Address - Phone:860-833-2375
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery