1336562156 NPI number — RYE SURGICAL CENTER, LLC

Table of content: (NPI 1336562156)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336562156 NPI number — RYE SURGICAL CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RYE SURGICAL CENTER, LLC
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:
Provider Other Organization Name Type Code:
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:
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NPI Number Information

NPI Number:
1336562156
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/10/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
944 CALEF HIGHWAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BARRINGTON
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03825
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-664-0100
Provider Business Mailing Address Fax Number:
603-664-0101

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
270 LAFAYETTE RD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RYE
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03870
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-319-1581
Provider Business Practice Location Address Fax Number:
603-319-1595
Provider Enumeration Date:
01/30/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SLEZAK
Authorized Official First Name:
JAN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/MEDICAL DIRECTOR
Authorized Official Telephone Number:
603-664-0100

Provider Taxonomy Codes

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

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