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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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