Provider Demographics
NPI:1144531740
Name:OFFICE BASED SURGICAL CARE, P.C.
Entity type:Organization
Organization Name:OFFICE BASED SURGICAL CARE, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:IMBER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-472-0082
Mailing Address - Street 1:1009 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0158
Mailing Address - Country:US
Mailing Address - Phone:212-472-0082
Mailing Address - Fax:
Practice Address - Street 1:1009 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0158
Practice Address - Country:US
Practice Address - Phone:212-472-0082
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY099299-1261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty