LIBERTY EYE SURGICAL CENTER (NPI# 1649325713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649325713 |
| Entity Type | Organization |
| Organization Name | LIBERTY EYE SURGICAL CENTER |
| Other Organization Name | LIBERTY SURGICAL CENTER |
| Practice Address |
9122 Blue Grass Rd Philadelphia PA 19114-3202 |
| Practice Telephone | 2156739231 |
| Practice Fax Number | 2156739236 |
| Mailing Telephone | 2156739231 |
| Mailing Fax Number | 2156739236 |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. EDWARD MICHAEL QUINN (ADMINISTRATOR) |
| Authorized Official Telephone | 2156739231 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
17401501 | PA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 1009642060001 | 05 |
| Other Name | Type Code |
|---|---|
| Liberty Surgical Center | Doing Business As Name - Organization |
| Street Address |
9122 BLUE GRASS RD |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19114-3202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447218433 | Liberty Eye Surgical Center LLC | Clinic/Center | 9122 Blue Grass Rd, Philadelphia, PA 19114-3202 | 2006-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164029906 | Phuoc Nguyen | Nurse Anesthetist, Certified Registered | Jefferson Torresdale Hospital, 10800 Knights Rd, Philadelphia, PA 19114 | 2020-10-05 |
| 1053921932 | Priyanka Patel | Dentist | Philadelphia Dental Smiles, 9140 Academy Road, Philadelphia, PA 19114 | 2020-08-05 |
| 1215419080 | Thomas Patrick Gallagher | Specialist/Technologist | 2708 Ruth Way, Philadelphia, PA 19114 | 2018-08-29 |
| 1558840223 | Alexis Wenger | Early Intervention Provider Agency | 3810 Aubrey Ave, Phila, PA 19114 | 2018-08-13 |
| 1245759232 | Newlands Health | Clinic/Center | 9625 Frankford Ave., Philadelphia, PA 19114 | 2017-09-12 |
| 1619491453 | Nazareth Physician Services Inc | Social Worker | 9815 Roosevelt Blvd Ste G, Philadelphia, PA 19114 | 2017-08-02 |
| 1326561606 | L.s. Share & Love Support Coordinating Agency, LLC | Case Management | 3600 Red Lion Road, Apt 68c, Philadelphia, PA 19114 | 2017-07-19 |
| 1760911952 | Charles C Richards II | Counselor | 2555 Welsh Rd, Apt 407, Philadelphia, PA 19114 | 2017-06-09 |
| 1801338686 | April Neuls | Physical Therapy Assistant | 4213 Lackland Place, Philadelphia, PA 19114 | 2016-11-10 |
| 1114317583 | Siji Cyriac | Physical Therapist | 9501 State Road, Philadelphia, PA 19114 | 2015-01-23 |
| Find all providers in zip 19114 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154839553 | American Access Care of Sp LLC | Clinic/Center | 2412 W Passyunk Ave # 14, Philadelphia, PA 19145-4114 | 2018-01-19 |
| 1265950802 | M&m Surgical Center PC | Clinic/Center | 1 Crescent Dr. Suite 300, Philadelphia, PA 19112 | 2017-09-05 |
| 1154787117 | The Pennsylvania Surgery and Laser Center LLC | Clinic/Center | 601 Franklin Mills Cir, Philadelphia, PA 19154-3124 | 2016-01-06 |
| 1023347226 | The Children's Hospital of Philadelphia | Clinic/Center | 34th & Civic Center Ave, Philadelphia, PA 19104 | 2009-12-17 |
| 1710114293 | Riverview Surgery Center At The Navy Yard Lp | Clinic/Center | Three Crescent Drive, Navy Yard Corporate Center, Philadelphia, PA 19112 | 2009-06-11 |
| 1083750103 | Perry Black | Clinic/Center | 219 N Broad St Fl -10th, Philadelphia, PA 19107-1519 | 2007-01-29 |
| 1447301122 | Planned Parenthood Southeastern Pennsylvania | Clinic/Center | 1144 Locust St, Philadelphia, PA 19107-6734 | 2007-01-16 |
| 1679658710 | Stadium Campus Ambulatory Surgical Center, LLC | Clinic/Center | 3340 S Broad St, Philadelphia, PA 19145-5802 | 2006-10-26 |
| 1215038252 | Red Lion Surgicenter, LLC | Clinic/Center | 240 Geiger Rd, Philadelphia, PA 19115-1008 | 2006-09-25 |
| 1447218433 | Liberty Eye Surgical Center LLC | Clinic/Center | 9122 Blue Grass Rd, Philadelphia, PA 19114-3202 | 2006-05-02 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19114 |
Please comment or provide details below to improve the information on LIBERTY EYE SURGICAL CENTER.
| 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.