Organization
LONG ISLAND AMBULATORY SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN WINTER (NURSE/ADMINISTRATOR)
(631) 231-4949
Entity
Organization
Contact information
Practice address
601 SUFFOLK AVE, BRENTWOOD, NY 11717-4309
(631) 231-4949
(631) 231-5421
Mailing address
601 SUFFOLK AVE, BRENTWOOD, NY 11717-4309
(631) 231-4949
(631) 231-5421
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
5154205R
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01180978
—
NY
Enumeration date
10/13/2006
Last updated
04/10/2017
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