Organization
ADVANCED SURGICAL ARTISTRY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY LEGG (CREDENTIALING COORDINATOR)
(347) 584-8903
Entity
Organization
Contact information
Practice address
8318 4TH AVE, BROOKLYN, NY 11209-4413
(718) 748-0500
Mailing address
8318 4TH AVE, BROOKLYN, NY 11209-4413
(718) 748-0500
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619954435
INDIVIDUAL NPI NUMBER
NY
Enumeration date
06/15/2020
Last updated
06/15/2020
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