LIBERTY EYE SURGICAL CENTER LLC NPI 1447218433

NPI Information

NPI: 1447218433
Provider Name: LIBERTY EYE SURGICAL CENTER LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 39D1023713

Address:
9122 BLUE GRASS RD
PHILADELPHIA, PA
ZIP 19114
Phone: (215) 673-9231
Get Directions

LIBERTY EYE SURGICAL CENTER LLC is an ambulatory surgical clinic center in Philadelphia, PA. LIBERTY EYE SURGICAL CENTER LLC NPI is 1447218433. The provider is registered as an organization entity type.

The provider's business location address is:

9122 BLUE GRASS RD
PHILADELPHIA, PA
ZIP 19114-202
Phone: (215) 673-9231
Fax: (215) 673-9236

The provider's authorized official is Dennis Slochower .
The authorized official title is Medical Director and has the following contact phone number (215) 673-9231.

The CLIA number assigned to this NPI record is 39D1023713 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/2/2006 and was last updated on 12/9/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	17401501	PENNSYLVANIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0001624000	OTHER	PENNSYLVANIA	KEYSTONE HMO
2	35387	MEDICAID	PENNSYLVANIA
3	3562638	OTHER	PENNSYLVANIA	AETNA HEALTHCARE
4	077418	MEDICARE ID-TYPE UNSPECIFIED	PENNSYLVANIA
5	P00086391	MEDICARE ID-TYPE UNSPECIFIED	PENNSYLVANIA
6	100964206001	MEDICAID	PENNSYLVANIA
7	0001624000	OTHER	PENNSYLVANIA	BLUE CROSS BLUE SHIELD
8	30019554	MEDICAID	PENNSYLVANIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »