Provider Demographics
NPI:1588808596
Name:VK SURGICAL ASSISTANTS, LLC
Entity Type:Organization
Organization Name:VK SURGICAL ASSISTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER/RNFA
Authorized Official - Prefix:
Authorized Official - First Name:VIKTORIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:LADUE
Authorized Official - Suffix:
Authorized Official - Credentials:RNFA
Authorized Official - Phone:908-347-9962
Mailing Address - Street 1:14 DOMINICK CT
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-3110
Mailing Address - Country:US
Mailing Address - Phone:973-921-0721
Mailing Address - Fax:973-467-2729
Practice Address - Street 1:14 DOMINICK CT
Practice Address - Street 2:
Practice Address - City:SHORT HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07078-3110
Practice Address - Country:US
Practice Address - Phone:973-921-0721
Practice Address - Fax:973-467-2729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-22
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR10656800163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty