Provider Demographics
NPI:1154034429
Name:CROSSINGS SURGERY CENTER, LLC
Entity type:Organization
Organization Name:CROSSINGS SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE CYCLEY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:CAVARETTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:716-208-1708
Mailing Address - Street 1:200 CROSSINGS BLVD
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2873
Mailing Address - Country:US
Mailing Address - Phone:716-208-1708
Mailing Address - Fax:
Practice Address - Street 1:300 CROSSINGS BLVD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2878
Practice Address - Country:US
Practice Address - Phone:716-208-1708
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical