Organization
SHADYSIDE SURGI-CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYMOND A CAPONE JR. M.D. (MEDICAL DIRECTOR)
(412) 363-6626
Entity
Organization
Contact information
Practice address
5727 CENTRE AVE, PITTSBURGH, PA 15206-3707
(412) 363-6626
(412) 363-7008
Mailing address
5727 CENTRE AVE, PITTSBURGH, PA 15206-3707
(412) 363-6626
(412) 363-7008
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001506187002
—
PA
01
—
0177
HIGHMARK ID
PA
Enumeration date
09/20/2006
Last updated
09/26/2013
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