Provider Demographics
NPI:1902215148
Name:21 READE PLACE ASC LLC
Entity Type:Organization
Organization Name:21 READE PLACE ASC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:SUNIL
Authorized Official - Middle Name:K
Authorized Official - Last Name:KHURANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-451-7217
Mailing Address - Street 1:21 READE PL
Mailing Address - Street 2:SUITE 3300
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-3912
Mailing Address - Country:US
Mailing Address - Phone:845-454-0222
Mailing Address - Fax:
Practice Address - Street 1:21 READE PL
Practice Address - Street 2:SUITE 3300
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-3912
Practice Address - Country:US
Practice Address - Phone:845-454-0222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0800XAmbulatory Health Care FacilitiesClinic/CenterEndoscopy