Organization
HILLSIDE DIAGNOSTIC AND TREATMENT CENTER, LLC
Active
Other names
Hillside SurgiCare
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOUG WISSMANN (FINANCE DIRECTOR)
(718) 291-8200
Entity
Organization
Contact information
Practice address
18811 HILLSIDE AVE, JAMAICA, NY 11423-1935
(718) 264-6700
(718) 264-6833
Mailing address
18811 HILLSIDE AVE, JAMAICA, NY 11423-1935
(718) 264-6700
(718) 264-6833
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02100856
—
NY
Enumeration date
10/23/2006
Last updated
10/02/2008
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