Organization
FIFTH AVENUE SURGERY CENTER, LLC
Active
Other names
French American Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES J RAAB (CHIEF FINANCIAL OFFICER)
(212) 772-6667
Entity
Organization
Contact information
Practice address
1049 5TH AVE, NEW YORK, NY 10028-0115
(212) 772-6667
(212) 988-8018
Mailing address
1049 5TH AVE, NEW YORK, NY 10028-0115
(212) 772-6667
(212) 988-8018
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
7002195R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003617
EMPIRE BLUE CROSS
NY
05
—
01238288
—
NY
01
—
0455952
CIGNA HEALTHCARE
NY
01
—
ANC282
OXFORD HEALTH PLANS
NY
01
—
NZ0867
HEALTH NET
NY
Enumeration date
09/28/2006
Last updated
06/03/2011
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