| Organization Name: | NORTHEAST SURGERY PC |
| NPI Number: | 1003086729 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOHN FARELLA (OWNER) |
| Mailing Address: | 666 Lexington Ave Ste 104 Mount Kisco |
| State: | NY US |
| Postal Code: | 105493638 |
| Phone Number: | 9145882665 |
| Fax Number: | |
| NPI Enumeration Date: | 03/10/2008 |
| NPI Last Update Date: | 03/12/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |