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Organization

STREET ROAD SURGERY CENTER, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EVELYN WITKIN M.D. (MEDICAL DIRECTOR)
(215) 355-7027
Entity
Organization

Contact information

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

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
2053
PA

Other

Enumeration date
01/23/2007
Last updated
08/22/2020
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