SHORE SURGICAL ASSISTING LLC (NPI# 1235497561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235497561 |
| Entity Type | Organization |
| Organization Name | SHORE SURGICAL ASSISTING LLC |
| Practice Address |
1070 Clearwater Ave Manahawkin NJ 08050-2303 |
| Practice Telephone | 7322361104 |
| Practice Fax Number | 6099782750 |
| Mailing Telephone | 7322361104 |
| Mailing Fax Number | 6099782750 |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2012-09-05 |
| Authorized Official Name | MR. DONN M HOOSACK (OWNER) |
| Authorized Official Telephone | 7322361104 |
| Authorized Official Credential | PA-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
25MP00132300 | NJ | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA | MH1342295 | 01 | |
| NJ | PHYSICIAN ASSISTANT LICENSE | 25MP00132300 | 01 |
| NJ | CDS | A00006300 | 01 |
| Street Address |
1070 CLEARWATER AVE |
| City | MANAHAWKIN |
| State | NJ |
| Zip Code | 08050-2303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720600588 | Ashley Egleston | Counselor | 297 Route 72 W Ste 35, Pmb 130, Manahawkin, NJ 08050 | 2020-05-14 |
| 1700428364 | Candice Lynn Ferretti | Counselor | Ocean Mental Health Services- Crisis Stabilization, 712 E. Bay Ave Ste 21-e, Manahawkin, NJ 08050 | 2019-10-15 |
| 1194366229 | A Place for Us Atlantic County Women's Center | Case Management | 98 Atlantis Ave, Manahawkin, NJ 08050 | 2019-09-30 |
| 1831669167 | Hcp Manahawkin Nj Opco, LLC | Alzheimer Center (Dementia Center) | 1272 Route 72 West, Manahawkin, NJ 08050 | 2018-11-29 |
| 1659893576 | Sara Rodino | Physical Therapist | 183 Anchor Ave, Manahawkin, NJ 08050 | 2017-07-12 |
| 1922520980 | Donnah Marie Celentano | Nurse Practitioner | 547 Route 72 East, Manahawkin, NJ 08050 | 2017-07-12 |
| 1639612757 | Annemarie Sacco | Counselor | 1140 Nj-72, Manahawkin, NJ 08050 | 2016-11-21 |
| 1255790028 | James G Johnson | Physical Therapy Assistant | 1361 Nj-72, Manahawkin, NJ 08050 | 2016-02-22 |
| 1760853188 | Jane Eremus-foster | Nurse Practitioner | 547 Route 72 W, Manahawkin, NJ 08050 | 2015-10-12 |
| 1710395579 | Stafford Medical P.a. | Specialist | 1346 Rt 72 W, Manahawkin, NJ 08050 | 2014-07-24 |
| Find all providers in zip 08050 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467062463 | Erica Josephine Lobuglio | Physician Assistant | 733 N Beers St Ste U3, Holmdel, NJ 07733-1513 | 2020-08-04 |
| 1407471493 | Angelice Grasso | Physician Assistant | 3 Holly Ln, Garfield, NJ 07026-3565 | 2020-06-15 |
| 1063036358 | Jaina Marie Lumkong | Physician Assistant | 905 Allwood Rd Ste 204, Clifton, NJ 07012-1946 | 2020-06-02 |
| 1740804384 | Allison Sy Tan | Physician Assistant | 10 Bahr Cir, Verona, NJ 07044-3200 | 2020-05-29 |
| 1114560851 | Brian Paul Leonhardt | Physician Assistant | 1113 Hospital Drive Professional Building East, Suite 100, Willingboro, NJ 08046 | 2019-10-25 |
| 1740830413 | Atara Hagler | Physician Assistant | 1500 Pleasant Valley Way Ste 101, West Orange, NJ 07052-2956 | 2019-09-16 |
| 1568943058 | Ekaterina M Rezvin | Physician Assistant | 80 Woodland Park Dr, Tenafly, NJ 07670-3028 | 2018-08-23 |
| 1225550353 | Kristen Cordiello | Physician Assistant | 1610 Route 88 Ste 203, Brick, NJ 08724-3018 | 2017-07-11 |
| 1710408232 | Angela Marie Freedman | Physician Assistant | 1 Riverview Plaza Multi Disciplinary Cancer Center, Red Bank, NJ 07701 | 2017-07-06 |
| 1063932259 | Matthew Gabriel | Physician Assistant | 25 Prospect Avernue, 2nd Floor, Hackensack, NJ 07601 | 2017-06-20 |
| Find all providers with the same taxonomy | ||||
| City | MANAHAWKIN |
| Zip Code | 08050 |
Please comment or provide details below to improve the information on SHORE SURGICAL ASSISTING LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.