Provider Demographics
| NPI: | 1780753533 |
|---|---|
| Name: | CHILDREN'S SURGICAL ASSOCIATES LTD |
| Entity type: | Organization |
| Organization Name: | CHILDREN'S SURGICAL ASSOCIATES LTD |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | EXECUTIVE DIRECTOR |
| Authorized Official - Prefix: | MRS |
| Authorized Official - First Name: | LINDA |
| Authorized Official - Middle Name: | C |
| Authorized Official - Last Name: | FLOCCO |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 267-425-9538 |
| Mailing Address - Street 1: | 3401 CIVIC CENTER BLVD |
| Mailing Address - Street 2: | |
| Mailing Address - City: | PHILADELPHIA |
| Mailing Address - State: | PA |
| Mailing Address - Zip Code: | 19104-4319 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 267-425-9538 |
| Mailing Address - Fax: | 267-425-9552 |
| Practice Address - Street 1: | 3401 CIVIC CENTER BLVD |
| Practice Address - Street 2: | |
| Practice Address - City: | PHILADELPHIA |
| Practice Address - State: | PA |
| Practice Address - Zip Code: | 19104-4319 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 215-590-1527 |
| Practice Address - Fax: | 215-590-1501 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-11-07 |
| Last Update Date: | 2024-07-11 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty |