Provider Demographics
NPI:1982739793
Name:STERLING SURGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:STERLING SURGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIDYK
Authorized Official - Suffix:
Authorized Official - Credentials:MSN APN
Authorized Official - Phone:609-286-5794
Mailing Address - Street 1:5 CLAYHOLE RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08087-2109
Mailing Address - Country:US
Mailing Address - Phone:609-296-5784
Mailing Address - Fax:609-296-5784
Practice Address - Street 1:5 CLAYHOLE RD
Practice Address - Street 2:
Practice Address - City:LITTLE EGG HARBOR TWP
Practice Address - State:NJ
Practice Address - Zip Code:08087-2109
Practice Address - Country:US
Practice Address - Phone:609-296-5784
Practice Address - Fax:609-296-5784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO06959300163WR0006X
NJ26NJ00054900363LA2200X, 363LF0000X, 364SP2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP2800XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPerioperativeGroup - Multi-Specialty
No163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0038491Medicaid
078602Medicare ID - Type Unspecified
Q14777Medicare UPIN