Provider Demographics
NPI:1659837714
Name:SOUTH JERSEY SURGICAL ASSISTING, LLC
Entity Type:Organization
Organization Name:SOUTH JERSEY SURGICAL ASSISTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:S
Authorized Official - Last Name:JUHAS
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CNOR, RNFA
Authorized Official - Phone:215-740-9208
Mailing Address - Street 1:65 MARSHALL DR
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-6018
Mailing Address - Country:US
Mailing Address - Phone:215-740-9208
Mailing Address - Fax:
Practice Address - Street 1:65 MARSHALL DR
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-6018
Practice Address - Country:US
Practice Address - Phone:215-740-9208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-13
Last Update Date:2020-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty