Provider Demographics
NPI:1013100817
Name:SURGICAL ASSOCIATED, INC.
Entity type:Organization
Organization Name:SURGICAL ASSOCIATED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:AKELLA
Authorized Official - Middle Name:SV
Authorized Official - Last Name:SARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:860-225-9431
Mailing Address - Street 1:40 HART ST
Mailing Address - Street 2:BUILDING B.
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052-1743
Mailing Address - Country:US
Mailing Address - Phone:860-225-9431
Mailing Address - Fax:860-229-1873
Practice Address - Street 1:40 HART ST
Practice Address - Street 2:BUILDING B.
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052-1743
Practice Address - Country:US
Practice Address - Phone:860-225-9431
Practice Address - Fax:860-229-1873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1232503Medicaid