Provider Demographics
NPI:1164739587
Name:GLOBAL SURGICAL ASSIST, LLC
Entity Type:Organization
Organization Name:GLOBAL SURGICAL ASSIST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PEYMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGHSOUDLOU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-773-2039
Mailing Address - Street 1:PO BOX 4206
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-8206
Mailing Address - Country:US
Mailing Address - Phone:973-773-2039
Mailing Address - Fax:973-773-2038
Practice Address - Street 1:1100 CLIFTON AVE
Practice Address - Street 2:FLOOR 2
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07013-3631
Practice Address - Country:US
Practice Address - Phone:973-773-2039
Practice Address - Fax:973-773-2038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-07
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty