Organization
AVICENNA ASC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAHRIAR DANESHVAR CASC (CEO/ADMINISTRATOR)
(718) 933-1900
Entity
Organization
Contact information
Practice address
2522 HUGHES AVE, BRONX, NY 10458-5112
(718) 933-1900
(718) 933-1938
Mailing address
2522 HUGHES AVE, BRONX, NY 10458-5112
(718) 933-1900
(718) 933-1938
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
NY
Other
Enumeration date
12/19/2013
Last updated
06/10/2015
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