Basic Information
| Provider Information | |||||||||
| NPI: | 1730253782 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EYNON SURGERY CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 681 SCRANTON CARBONDALE HWY | ||||||||
| Address2: | |||||||||
| City: | EYNON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 184031022 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5708765900 | ||||||||
| FaxNumber: | 5708765300 | ||||||||
| Practice Location | |||||||||
| Address1: | 681 SCRANTON CARBONDALE HWY | ||||||||
| Address2: | |||||||||
| City: | EYNON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 184031022 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5708765900 | ||||||||
| FaxNumber: | 5708765300 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | SHAH | ||||||||
| AuthorizedOfficialFirstName: | NAYAN | ||||||||
| AuthorizedOfficialMiddleName: | C | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5708765900 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QE0800X | 17241501 | PA | Y | Ambulatory Health Care Facilities | Clinic/Center | Endoscopy |
No ID Information.