Provider Demographics
NPI:1699882548
Name:METRO FIRST ASSISTANTS, INC.
Entity type:Organization
Organization Name:METRO FIRST ASSISTANTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED SURGICAL ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:HERTZENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:CST/CFA/LSA
Authorized Official - Phone:763-694-9248
Mailing Address - Street 1:5130 HOLLY LN N UNIT 3
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55446-1773
Mailing Address - Country:US
Mailing Address - Phone:763-694-9248
Mailing Address - Fax:763-694-0293
Practice Address - Street 1:5130 HOLLY LN N UNIT 3
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55446-1773
Practice Address - Country:US
Practice Address - Phone:763-694-9248
Practice Address - Fax:763-694-0293
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00271246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical TechnologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1588646970Medicare UPIN