Provider Demographics
NPI:1821036138
Name:GAMMA SURGERY CENTER LLC
Entity type:Organization
Organization Name:GAMMA SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-609-1168
Mailing Address - Street 1:107 GAMMA DRIVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15238-2917
Mailing Address - Country:US
Mailing Address - Phone:412-963-7917
Mailing Address - Fax:412-963-7918
Practice Address - Street 1:107 GAMMA DRIVE
Practice Address - Street 2:SUITE 200
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-2917
Practice Address - Country:US
Practice Address - Phone:412-963-7917
Practice Address - Fax:412-963-7918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA20831501261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA39C0001226Medicare Oscar/Certification
PA104901Medicare PIN