Organization
AMBULATORY SURGERY CENTER AT THE JEFFERSON PAIN & REHAB CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN KEUN-SANG LEE M.D. (MEDICAL DIRECTOR/PRESIDENT)
(412) 885-5400
Entity
Organization
Contact information
Practice address
4735 CLAIRTON BLVD, PITTSBURGH, PA 15236-2115
(412) 885-5400
(412) 885-1773
Mailing address
4735 CLAIRTON BLVD, PITTSBURGH, PA 15236-2115
(412) 885-5400
(412) 885-1773
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0016772370001
—
PA
Enumeration date
10/08/2012
Last updated
01/20/2015
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