Organization
ALISA SURGICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TSIVA GUTMAN (CHEF FINANCIAL OFFICER)
(215) 722-0958
Entity
Organization
Contact information
Practice address
8422 BUSTLETON AVE, PHILADELPHIA, PA 19152
(215) 722-0958
(215) 722-0978
Mailing address
8422 BUSTLETON AVE, PHILADELPHIA, PA 19152
(215) 722-0958
(215) 722-0978
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0009775510002
—
PA
Enumeration date
02/21/2007
Last updated
08/22/2020
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