Provider Demographics
NPI:1417325606
Name:INFINITY SURGICAL ASSISTING
Entity Type:Organization
Organization Name:INFINITY SURGICAL ASSISTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SURGICAL ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:MORISSEAU
Authorized Official - Suffix:
Authorized Official - Credentials:SURGICAL ASSISTANT
Authorized Official - Phone:718-614-6838
Mailing Address - Street 1:1669 UPLAND LKS
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-4740
Mailing Address - Country:US
Mailing Address - Phone:718-614-6838
Mailing Address - Fax:
Practice Address - Street 1:1669 UPLAND LKS
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77043-4740
Practice Address - Country:US
Practice Address - Phone:718-614-6838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-04
Last Update Date:2015-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty