Provider Demographics
NPI:1891125118
Name:SUMMIT SURGICAL ASSISTANTS LLC
Entity type:Organization
Organization Name:SUMMIT SURGICAL ASSISTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:CAMBRIA
Authorized Official - Suffix:
Authorized Official - Credentials:PA
Authorized Official - Phone:917-449-8144
Mailing Address - Street 1:14 CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2041
Mailing Address - Country:US
Mailing Address - Phone:917-449-8144
Mailing Address - Fax:
Practice Address - Street 1:14 CHERRY LN
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-2041
Practice Address - Country:US
Practice Address - Phone:917-449-8144
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00261600363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Single Specialty