Organization
BAYSIDE SURGICAL CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSS SAMUEL COHEN D.P.M. (PRESIDENT)
(410) 761-4190
Entity
Organization
Contact information
Practice address
8023 RITCHIE HWY, PASADENA, MD 21122-7107
(410) 761-4190
(410) 761-0265
Mailing address
8023 RITCHIE HWY, PASADENA, MD 21122-7107
(410) 761-4190
(410) 761-0265
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
A1167
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02AP
CAREFIRST BS PROV NUMBER
MD
01
—
MT8
BS FEDERAL PROV NUMBER
MD
Enumeration date
08/31/2006
Last updated
06/01/2011
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