Provider Demographics
NPI:1598202798
Name:FIRST ASSIST SURGICAL SOLUTIONS, LLC
Entity Type:Organization
Organization Name:FIRST ASSIST SURGICAL SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:917-821-7524
Mailing Address - Street 1:370 W PLEASANTVIEW AVE
Mailing Address - Street 2:#2-215
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-8004
Mailing Address - Country:US
Mailing Address - Phone:917-821-7524
Mailing Address - Fax:
Practice Address - Street 1:370 W PLEASANTVIEW AVE
Practice Address - Street 2:#2-215
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-8004
Practice Address - Country:US
Practice Address - Phone:917-821-7524
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00230900363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty