Organization
FOXHALL AMBULATORY SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD J POLICASTRO (ADMINISTRATOR)
(845) 616-9003
Entity
Organization
Contact information
Practice address
741 GRANT AVE, LAKE KATRINE, NY 12449-5350
(845) 943-6039
Mailing address
741 GRANT AVE, LAKE KATRINE, NY 12449-5350
(845) 943-6039
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
5501211R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03106536
—
NY
Enumeration date
10/19/2010
Last updated
10/19/2010
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