Provider Demographics
NPI:1881986685
Name:NORTH JERSEY SURGICAL ASSISTANT SERVICES, LLC
Entity type:Organization
Organization Name:NORTH JERSEY SURGICAL ASSISTANT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LASKI
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:201-727-9330
Mailing Address - Street 1:455 KIPP AVE
Mailing Address - Street 2:FLOOR 2
Mailing Address - City:HASBROUCK HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07604-2614
Mailing Address - Country:US
Mailing Address - Phone:201-727-9330
Mailing Address - Fax:201-425-4527
Practice Address - Street 1:455 KIPP AVE
Practice Address - Street 2:FLOOR 2
Practice Address - City:HASBROUCK HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07604-2614
Practice Address - Country:US
Practice Address - Phone:201-727-9330
Practice Address - Fax:201-425-4527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-11
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Multi-Specialty