Provider Demographics
NPI:1942643499
Name:QUALITY SURGICAL ASSISTING LIMITED LIABILITY COMPANY
Entity Type:Organization
Organization Name:QUALITY SURGICAL ASSISTING LIMITED LIABILITY COMPANY
Other - Org Name:DIANE JANNOTTA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:JANNOTTA
Authorized Official - Suffix:
Authorized Official - Credentials:CRNFA
Authorized Official - Phone:609-703-8170
Mailing Address - Street 1:PO BOX 553
Mailing Address - Street 2:
Mailing Address - City:LONGPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:08403-0553
Mailing Address - Country:US
Mailing Address - Phone:609-703-8170
Mailing Address - Fax:609-541-4986
Practice Address - Street 1:115 N 34TH AVE
Practice Address - Street 2:
Practice Address - City:LONGPORT
Practice Address - State:NJ
Practice Address - Zip Code:08403-1622
Practice Address - Country:US
Practice Address - Phone:609-703-8170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-15
Last Update Date:2016-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR08790500163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty