Organization
LACKAWANNA SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A FRATTALI MD (MEDICAL DIRECTOR)
(570) 346-7900
Entity
Organization
Contact information
Practice address
415 ADAMS AVENUE, SCRANTON, PA 18510
(570) 504-8100
(570) 504-8106
Mailing address
PO BOX 3445, SCRANTON, PA 18505-0445
(570) 504-8100
(570) 504-8106
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
21511501
PA
Other
Enumeration date
12/01/2006
Last updated
08/16/2007
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