Provider Demographics
NPI:1871602045
Name:ATLANTIC SURGICAL ASSOCIATES LLC
Entity type:Organization
Organization Name:ATLANTIC SURGICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:CLONEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-424-7522
Mailing Address - Street 1:806 SEABURY AVE
Mailing Address - Street 2:PO BOX 412
Mailing Address - City:MILFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19963-2223
Mailing Address - Country:US
Mailing Address - Phone:302-424-7522
Mailing Address - Fax:
Practice Address - Street 1:806 SEABURY AVE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-2223
Practice Address - Country:US
Practice Address - Phone:302-424-7522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty