Laser Spine Surgery Center of Pennsylavnia, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

LASER SPINE SURGERY CENTER OF PENNSYLAVNIA, LLC

Practice address

656 E. Swedesford Road
Suite 105
Wayne, PA 19087

Phone

(215) 845-0566

Fax

(484) 253-1790

NPI assigned

Aug 25, 2009

Organization subpart

Yes

Parent organization

LSI HOLDCO, LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Michael W Perry, MD

Title

Medical Director

Phone

(813) 289-9613

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485302400000",
    "number": "1366675316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5332 AVION PARK DRIVE",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33607",
            "telephone_number": "813-682-2944",
            "fax_number": "484-253-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "656 E. SWEDESFORD ROAD",
            "address_2": "SUITE 105",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "19087",
            "telephone_number": "215-845-0566",
            "fax_number": "484-253-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LASER SPINE SURGERY CENTER OF PENNSYLAVNIA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LSI HOLDCO, LLC",
        "enumeration_date": "2009-08-25",
        "last_updated": "2017-01-25",
        "status": "A",
        "authorized_official_last_name": "PERRY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "813-289-9613",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa-Marie Lanciotti, PT
• Kaelee Landis
• Thomas L. Landis, M.ED.
• Laser Spine Institute LLC Sole MBR (Spine DME Solutions LLC)
• Laser Spine Institute of Pennsylvania, LLC
• Sharon Lausch, M. ED., BCBA, LBS
• Bryant Tin Le, PHARMD
• Carin Marice Lefkowitz, PSY.D.
• David S. Leidy, D.M.D.
• Karan Lemoine

• Ambulatory Surgical Clinic/Center in Wayne, PA
• Providers in Wayne, PA by specialty
• Ambulatory Surgical Clinic/Center in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.