Organization
VALLEYGATE SURGERY CENTER OF NE PA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA KENNERSON (DIRECTOR OF STRATEGIC DEVELOPMENT)
(337) 356-7044
Entity
Organization
Contact information
Practice address
423 3RD AVE STE D, KINGSTON, PA 18704-5809
(337) 356-7044
Mailing address
2028 LITHO PL, FAYETTEVILLE, NC 28304-2537
Taxonomy
Speciality
Code
Description
License number
State
207LP3000X
Pediatric Anesthesiology Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
—
—
Other
Enumeration date
09/24/2025
Last updated
09/24/2025
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