Basic Information
| Provider Information | |||||||||
| NPI: | 1902398688 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AXIA ABINGTON SURGERY CENTER, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 22772 | ||||||||
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| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100872772 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8566696050 | ||||||||
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| Practice Location | |||||||||
| Address1: | 467 PENNSYLVANIA AVE STE 202A | ||||||||
| Address2: | |||||||||
| City: | FORT WASHINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190343420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2674606235 | ||||||||
| FaxNumber: | 2158873291 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/30/2018 | ||||||||
| LastUpdateDate: | 05/24/2021 | ||||||||
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| AuthorizedOfficialLastName: | SABO | ||||||||
| AuthorizedOfficialFirstName: | KAREN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CREDENTIALING SPECIALIST | ||||||||
| AuthorizedOfficialTelephone: | 6104824795 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 05/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.