Organization
72ND STREET SURGERY REALTY CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDMUND KWAN MD (OWNER)
(212) 734-4488
Entity
Organization
Contact information
Practice address
302 E 72ND ST, NEW YORK, NY 10021-4772
(212) 734-4488
Mailing address
302 E 72ND ST, NEW YORK, NY 10021-4772
(212) 734-4488
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G06367N
UPIN
NY
Enumeration date
03/10/2008
Last updated
03/10/2008
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