Provider Demographics
NPI:1285087106
Name:BALA CYNWYD SURGERY CENTER
Entity type:Organization
Organization Name:BALA CYNWYD SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:VICKI
Authorized Official - Middle Name:
Authorized Official - Last Name:EDELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-261-1860
Mailing Address - Street 1:100 PRESIDENTIAL BLVD
Mailing Address - Street 2:FOURTH FLOOR
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1108
Mailing Address - Country:US
Mailing Address - Phone:781-261-1860
Mailing Address - Fax:781-610-9895
Practice Address - Street 1:100 PRESIDENTIAL BLVD
Practice Address - Street 2:FOURTH FLOOR
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1108
Practice Address - Country:US
Practice Address - Phone:781-261-1860
Practice Address - Fax:781-610-9895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-15
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical