Organization
NORTHEAST OHIO SURGERY CENTER, LLC
Active
Other names
Northeast Ohio Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
JEROME B. YOKIEL MD (PRESIDENT, MEDICAL DIRECTOR)
(216) 360-9610
Entity
Organization
Contact information
Practice address
3755 ORANGE PLACE, SUITE 102, ORANGE VILLAGE, OH 44122-4455
(216) 360-9610
(216) 360-9606
Mailing address
3755 ORANGE PLACE, SUITE 102, ORANGE VILLAGE, OH 44122-4455
(216) 360-9610
(216) 360-9606
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0673AS
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000227520
BLUE CROSS/BLUE SHIELD
OH
05
—
2391737
—
OH
01
—
352498400
OHIO DEPT OF LABOR
OH
01
—
490005606
MEDICARE RAILROAD
OH
Enumeration date
07/12/2005
Last updated
03/25/2011
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