Provider Demographics
NPI:1578314738
Name:PROASSIST SURGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:PROASSIST SURGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELLA
Authorized Official - Middle Name:ALEXA
Authorized Official - Last Name:URSICK
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:201-919-3440
Mailing Address - Street 1:111 TOWN SQUARE PL STE 1203
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07310-2784
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:973-671-3080
Practice Address - Street 1:100 MADISON AVE
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6136
Practice Address - Country:US
Practice Address - Phone:201-919-3440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty