Provider Demographics
NPI:1053629014
Name:MEDASSURANT
Entity Type:Organization
Organization Name:MEDASSURANT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RECRUITER
Authorized Official - Prefix:
Authorized Official - First Name:SARNIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-809-4000
Mailing Address - Street 1:71 MONTAGUE PL
Mailing Address - Street 2:FLOOR 1
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-2819
Mailing Address - Country:US
Mailing Address - Phone:551-689-7355
Mailing Address - Fax:
Practice Address - Street 1:71 MONTAGUE PL
Practice Address - Street 2:FLOOR 1
Practice Address - City:MONTCLAIR
Practice Address - State:NJ
Practice Address - Zip Code:07042-2819
Practice Address - Country:US
Practice Address - Phone:551-689-7355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-23
Last Update Date:2010-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR13475100251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care