Organization
RADIANCE-A PRIVATE OUTPATIENT SURGERY CENTER LLC
Active
Other names
Radiance Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
SUDHIR RAO MD (PRESIDENT/CEO)
(412) 220-2336
Entity
Organization
Contact information
Practice address
701 BOYCE RD, BRIDGEVILLE, PA 15017-1225
(412) 220-2336
(412) 220-2279
Mailing address
701 BOYCE RD, BRIDGEVILLE, PA 15017-1225
(412) 220-2336
(412) 220-2279
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1760
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0253
BLUE SHIELD BLUE CROSS
PA
05
—
102775173 001
—
PA
01
—
261596
HEALTH AMERICA
PA
Enumeration date
07/31/2006
Last updated
06/03/2022
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