Provider Demographics
NPI:1427175819
Name:LEXINGTON SURGICAL ASSOC INC
Entity type:Organization
Organization Name:LEXINGTON SURGICAL ASSOC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:P
Authorized Official - Last Name:ISENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:814-943-7040
Mailing Address - Street 1:1701 12TH AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-3100
Mailing Address - Country:US
Mailing Address - Phone:814-943-7040
Mailing Address - Fax:814-943-7002
Practice Address - Street 1:1701 12TH AVE
Practice Address - Street 2:SUITE D
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-3100
Practice Address - Country:US
Practice Address - Phone:814-943-7040
Practice Address - Fax:814-943-7002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
120586Medicare PIN