Organization Name: | VALLEY ADVANCED GAMMA KNIFE, LLC |
NPI Number: | 1043294820 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK GABRIEL (PRINCIPAL) |
Mailing Address: | 2407 Butler St Easton |
State: | PA US |
Postal Code: | 180425302 |
Phone Number: | 6102537444 |
Fax Number: | 6102535771 |
NPI Enumeration Date: | 12/05/2005 |
NPI Last Update Date: | 07/08/2007 |
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: |