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Organization

UPSTATE ORTHOPEDICS AMBULATORY SURGERY CENTER LLC

Active
Other names
Upstate Orthopedics ASC
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JON DAVID VAN VALKENBURG (EXECUTIVE DIRECTOR)
(315) 432-5971
Entity
Organization

Contact information

Practice address
6620 FLY ROAD, SUITE 300, EAST SYRACUSE, NY 13057
(315) 432-5960
(315) 432-5979
Mailing address
6620 FLY ROAD, SUITE 300, EAST SYRACUSE, NY 13057
(315) 432-5960
(315) 432-5979

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
3321200R
NY
261QA1903X
Ambulatory Surgical Clinic/Center

Other

Enumeration date
05/14/2009
Last updated
05/05/2022
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