Provider Demographics
NPI:1396074522
Name:ADVANCED SURGERY CENTER, LLC
Entity type:Organization
Organization Name:ADVANCED SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FIORILLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:845-623-6141
Mailing Address - Street 1:150 S PEARL ST
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:NY
Mailing Address - Zip Code:10965-2253
Mailing Address - Country:US
Mailing Address - Phone:845-623-6141
Mailing Address - Fax:845-623-1998
Practice Address - Street 1:150 S PEARL ST
Practice Address - Street 2:
Practice Address - City:PEARL RIVER
Practice Address - State:NY
Practice Address - Zip Code:10965-2253
Practice Address - Country:US
Practice Address - Phone:845-623-6141
Practice Address - Fax:845-623-1998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-17
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical