Organization
NORTHEAST REGIONAL SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBIN SANTASANIA (BILLING SUPERVISOR)
(570) 970-1173
Entity
Organization
Contact information
Practice address
11 GALLAGHER DR, PLAINS, PA 18705-1146
(570) 970-1030
(570) 270-0577
Mailing address
11 GALLAGHER DR, PLAINS, PA 18705-1146
(570) 970-1030
(570) 270-0577
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008875000001
—
PA
01
—
125451600
DEPT OF LABOR PROVIDER NU
PA
01
—
3346749
AETNA PROVIDER NUMBER
PA
01
—
398835
HIGH MARK
PA
Enumeration date
07/28/2005
Last updated
05/29/2024
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