Provider Demographics
NPI:1184034092
Name:ASSURE SURGICAL PC
Entity Type:Organization
Organization Name:ASSURE SURGICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:K
Authorized Official - Last Name:FUNT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-295-0404
Mailing Address - Street 1:19 IRVING PL
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1229
Mailing Address - Country:US
Mailing Address - Phone:516-295-0404
Mailing Address - Fax:516-368-3768
Practice Address - Street 1:19 IRVING PL
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1229
Practice Address - Country:US
Practice Address - Phone:516-295-0404
Practice Address - Fax:516-368-3768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCERT # 1855174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1855OtherAMERICAN ASSOCIATION FOR ACCCREDITATION OF AMBULATORY SURGERY FACILITIIES, INC.