Provider Demographics
NPI:1801855127
Name:CENTER FOR THE SURGICAL ARTS LLC
Entity Type:Organization
Organization Name:CENTER FOR THE SURGICAL ARTS LLC
Other - Org Name:CSA
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:AGHA RAAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-777-7702
Mailing Address - Street 1:3107 FAIRWAY DRIVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602
Mailing Address - Country:US
Mailing Address - Phone:814-414-4848
Mailing Address - Fax:814-201-2256
Practice Address - Street 1:3107 FAIRWAY DRIVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16602
Practice Address - Country:US
Practice Address - Phone:814-414-4848
Practice Address - Fax:814-201-2256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-23
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1843261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
1813779OtherBLUE SHIELD
PA1016116300002Medicaid
PA0423OtherHIGHMARK