Provider Demographics
NPI:1013525807
Name:INTEGRITY SURGICAL ASSISTANCE
Entity Type:Organization
Organization Name:INTEGRITY SURGICAL ASSISTANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BSN, RNFA
Authorized Official - Prefix:
Authorized Official - First Name:KIERSTEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCULLY
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RNFA
Authorized Official - Phone:609-847-1709
Mailing Address - Street 1:1031 POTTS MILL RD
Mailing Address - Street 2:
Mailing Address - City:BORDENTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08505-4209
Mailing Address - Country:US
Mailing Address - Phone:609-847-1709
Mailing Address - Fax:
Practice Address - Street 1:1031 POTTS MILL RD
Practice Address - Street 2:
Practice Address - City:BORDENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08505-4209
Practice Address - Country:US
Practice Address - Phone:609-847-1709
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-17
Last Update Date:2020-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1710413125OtherPRIVATE HEALTH INSURANCE