# STREET ROAD SURGERY CENTER, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1134273311
- **Authorized official:** DR. EVELYN WITKIN M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (215) 355-7027

## Contact information

- **Practice address:** 4979 OLD STREET RD, TREVOSE, PA 19053-6222
- **Practice address phone:** (215) 355-7027
- **Practice address fax:** (215) 355-7028
- **Mailing address:** 4979 OLD STREET RD, TREVOSE, PA 19053-6222
- **Mailing address phone:** (215) 355-7027
- **Mailing address fax:** (215) 355-7028

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 2053 | PA | Yes |

## Other

- **Enumeration date:** 01/23/2007
- **Last updated:** 08/22/2020