1306063672 NPI number — PARKWAY SURGERY CENTER

Table of content: (NPI 1306063672)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306063672 NPI number — PARKWAY SURGERY CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PARKWAY SURGERY CENTER
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SAL P. CALABRO, M.D. ASSOCIATES
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306063672
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2401 PENNSYLVANIA AVE
Provider Second Line Business Mailing Address:
SUITE 1A5
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19130-3010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-232-8200
Provider Business Mailing Address Fax Number:
215-232-8220

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2401 PENNSYLVANIA AVE
Provider Second Line Business Practice Location Address:
SUITE 1A5
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19130-3010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-232-8200
Provider Business Practice Location Address Fax Number:
215-232-8220
Provider Enumeration Date:
04/19/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CALABRO
Authorized Official First Name:
SALVATORE
Authorized Official Middle Name:
PETER
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
212-232-8200

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  15651501 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)