Provider Demographics
NPI:1346488806
Name:BURLCO SURGICAL ASSIST
Entity Type:Organization
Organization Name:BURLCO SURGICAL ASSIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RNFA
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:ANGEL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:856-829-1182
Mailing Address - Street 1:400 KATHLEEN AVE
Mailing Address - Street 2:
Mailing Address - City:CINNAMINSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08077-2932
Mailing Address - Country:US
Mailing Address - Phone:856-829-1182
Mailing Address - Fax:
Practice Address - Street 1:400 KATHLEEN AVE
Practice Address - Street 2:
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077-2932
Practice Address - Country:US
Practice Address - Phone:856-829-1182
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR0543900163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty