Provider Demographics
NPI:1588267546
Name:BINGHAMTON ASC LLC
Entity type:Organization
Organization Name:BINGHAMTON ASC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMBURSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:607-341-4141
Mailing Address - Street 1:530 COLUMBIA DR
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:NY
Mailing Address - Zip Code:13790-3301
Mailing Address - Country:US
Mailing Address - Phone:607-341-4141
Mailing Address - Fax:072-376-0009
Practice Address - Street 1:530 COLUMBIA DR
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:NY
Practice Address - Zip Code:13790-3301
Practice Address - Country:US
Practice Address - Phone:607-821-0400
Practice Address - Fax:607-821-0401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty