# ADVANCED SPECIALTY SURGERY

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

## Provider details

- **NPI number:** 1316545809
- **Authorized official:** AMANDA LYNN RICCA (CEO)
- **Authorized official phone:** (610) 628-4243

## Contact information

- **Practice address:** 124 N NARBERTH AVE, NARBERTH, PA 19072-2211
- **Practice address phone:** (484) 434-7500
- **Practice address fax:** (484) 434-7501
- **Mailing address:** PO BOX 358, DOUGLASSVILLE, PA 19518-0358
- **Mailing address phone:** (610) 628-4243
- **Mailing address fax:** (215) 628-2704

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208VP0000X | Pain Medicine Physician | — | NULL | Yes |
| 208VP0000X | Pain Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/15/2020
- **Last updated:** 10/15/2020