# FSLJC, LLC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** THE RENAISSANCE CENTER FOR PLASTIC SURGERY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346266087
- **Authorized official:** MS. SUSAN J COLLINI RT (R) RDMS RDCS (ADMINISTRATOR)
- **Authorized official phone:** (570) 674-6525

## Contact information

- **Practice address:** 1845 MEMORIAL HWY, SHAVERTOWN, PA 18708-1482
- **Practice address phone:** (570) 674-6525
- **Practice address fax:** (570) 674-6520
- **Mailing address:** 1845 MEMORIAL HWY, SHAVERTOWN, PA 18708-1482
- **Mailing address phone:** (570) 674-6525
- **Mailing address fax:** (570) 674-6520

## Taxonomy

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

## Other

- **Enumeration date:** 07/14/2006
- **Last updated:** 05/09/2017