Organization
NORTHEAST SURGERY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN FARELLA MD (OWNER)
(914) 588-2665
Entity
Organization
Contact information
Practice address
666 LEXINGTON AVE STE 104, MOUNT KISCO, NY 10549-3638
(914) 588-2665
Mailing address
311 NORTH ST STE 408, WHITE PLAINS, NY 10605-2215
(914) 588-2665
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
163861-1
LICENSE
NY
01
—
E98544
UPIN
NY
Enumeration date
03/10/2008
Last updated
03/12/2009
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