Provider Demographics
NPI:1447491485
Name:SURGIFIRST LLC
Entity type:Organization
Organization Name:SURGIFIRST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:EUSTACE
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN CNOR CRNFA
Authorized Official - Phone:908-303-6696
Mailing Address - Street 1:87 SIDNEY SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08801-3510
Mailing Address - Country:US
Mailing Address - Phone:908-303-6696
Mailing Address - Fax:908-713-9691
Practice Address - Street 1:87 SIDNEY SCHOOL RD
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:NJ
Practice Address - Zip Code:08801-3510
Practice Address - Country:US
Practice Address - Phone:908-303-6696
Practice Address - Fax:908-713-9691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-22
Last Update Date:2009-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NO07860900163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First AssistantGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1306830278OtherNPI # INDIVIDUAL