MAIN LINE PA ENDOSCOPY ASC LP


Address: 333 E City Line Ave, Two Bala Plaza, Suite 30, Bala Cynwyd, PA 19004-1501
Phone: 6106447274

MAIN LINE PA ENDOSCOPY ASC LP (NPI# 1235239054) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1235239054
Entity Type Organization
Organization Name MAIN LINE PA ENDOSCOPY ASC LP
Other Organization Name MAIN LINE ENDOSCOPY CENTER, EAST
Practice Address 333 E City Line Ave
Two Bala Plaza, Suite 30
Bala Cynwyd
PA 19004-1501
Practice Telephone 6106447274
Practice Fax Number 6106447276
Mailing Telephone 6106447274
Mailing Fax Number 6106447276
Enumeration Date 2006-09-22
Last Update Date 2014-04-02
Authorized Official Name MR. PHILLIP A CLENDENIN (PRESIDENT)
Authorized Official Telephone 6156651283
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QA1903X Clinic/Center
Specialization: Ambulatory Surgical
16701501 PA Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
PA RAILROAD MEDICARE P00478537 01

Other Provider/Organization Names

Other Name Type Code
Main Line Endoscopy Center, East Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1023115078 Main Line Pa Endoscopy Asc Lp Clinic/Center 325 West Central Ave, Lower Level, Malvern, PA 19355-3219 2006-09-20

Office Location

Street Address 333 E CITY LINE AVE
TWO BALA PLAZA, SUITE 30
City BALA CYNWYD
State PA
Zip Code 19004-1501

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1003363235 Catherine Kazanjian Nurse Practitioner 333 E City Ave Ste Il27, Bala Cynwyd, PA 19004 2016-09-06
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Taxonomy Information

Taxonomy Code 261QA1903X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Ambulatory Surgical

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
1518575778 Eye Surgery of The Main Line, LLC Clinic/Center 333 E City Avenue, Two Bala Plaza, Bala Cynwyd, PA 19004-1501 2020-07-14
1134127426 Delaware Valley Medical Management Clinic/Center 100 Presidential Blvd, 4th Floor, Bala Cynwyd, PA 19004-1108 2005-07-11
1285087106 Bala Cynwyd Surgery Center Clinic/Center 100 Presidential Blvd, Fourth Floor, Bala Cynwyd, PA 19004-1108 2016-07-15
1184678682 Main Line Surgery Center, LLC Clinic/Center 10 Presidential Blvd, Suite 200, Bala Cynwyd, PA 19004-1107 2006-05-19
1346224490 Nevyas Eye Associates, PC Clinic/Center 333 E City Ave, 2 Bala Plaza, Bala Cynwyd, PA 19004-1501 2005-12-02

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1053934919 Doylestown Surgery Center, LLC Clinic/Center 593 West State Street, Doylestown, PA 18901 2020-05-26
1811534555 Midlantic Urology Surgery Center, LLC Clinic/Center Valley Forge Office Center, Suite 100, 676-656 East Swedesford Road, Wayne, PA 19087 2019-12-02
1750927190 Hermitage Endoscopy Center Inc Clinic/Center 949 N Hermitage Road, Hermitage, PA 16148 2019-11-20
1508400920 Nazareth Endoscopy Center, LLC Clinic/Center 2401 Northampton St Ste 220, Easton, PA 18045-2764 2019-10-29
1235788878 Integrated Surgical Institute, LLC Clinic/Center West Ridge Business Campus, 1001 James Drive, Leesport, PA 19533 2019-09-06
1841759040 Beaver Valley Ambulatory Surgery Center, LLC Clinic/Center 79 Wagner Road, Suite 101, Monaca, PA 15061-2489 2019-03-18
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Competitor

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City BALA CYNWYD
Zip Code 19004

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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