Provider Demographics
NPI:1265541833
Name:WASHINGTON SURGICAL SERVICES, P.C.
Entity type:Organization
Organization Name:WASHINGTON SURGICAL SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLADARES
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:724-229-1344
Mailing Address - Street 1:95 LEONARD AVE
Mailing Address - Street 2:BLG. 1, STE. 400
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-3368
Mailing Address - Country:US
Mailing Address - Phone:724-229-1344
Mailing Address - Fax:724-229-1347
Practice Address - Street 1:95 LEONARD AVE
Practice Address - Street 2:BLG. 1, STE. 400
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301-3368
Practice Address - Country:US
Practice Address - Phone:724-229-1344
Practice Address - Fax:724-229-1347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-009646-L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAH47483Medicare UPIN
PA076383Medicare ID - Type Unspecified