Organization
LAUREL LASER & SURGERY CENTER, L.P.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WHITNEY N SUTLEY RN (CLINICAL DIRECTOR / ADMINISTRATOR)
(814) 849-6561
Entity
Organization
Contact information
Practice address
52 WATERFORD PIKE, BROOKVILLE, PA 15825-2518
(814) 849-0898
(814) 849-2890
Mailing address
52 WATERFORD PIKE, BROOKVILLE, PA 15825-2518
(814) 849-0898
(814) 849-2890
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
11351500
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001805435
—
PA
01
—
1343
HIGHMARK BLUE CROSS BLUE
—
01
—
138792
HEALTH AMERICA/ASSURANCE
—
01
—
216106
UPMC
PA
01
—
2326303
AETNA
—
01
—
490004660
RAILROAD MEDICARE
—
Enumeration date
06/14/2005
Last updated
06/10/2024
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