# QUEENS SURGICAL CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083220123
- **Authorized official:** MR. BRIAN S PUN (MANAGING MEMBER)
- **Authorized official phone:** (347) 592-1120

## Contact information

- **Practice address:** 3636 MAIN ST STE 1S, FLUSHING, NY 11354-6517
- **Practice address phone:** (347) 592-1120
- **Practice address fax:** (800) 550-4779
- **Mailing address:** 3636 MAIN ST STE 1S, FLUSHING, NY 11354-6517
- **Mailing address phone:** (347) 592-1120
- **Mailing address fax:** (800) 550-4779

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223D0004X | Dental Anesthesiology | — | NULL | — |
| 1223D0004X | Dental Anesthesiology | — | — | — |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/22/2020
- **Last updated:** 02/05/2025