Organization Name: | METROPOLITAN SURGICAL SERVICES LLC |
NPI Number: | 1053730275 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CHAD JASON ITZKOVICH (MANAGING MEMBER) |
Mailing Address: | 2740 State Route 10 Suite 104 Morris Plains |
State: | NJ US |
Postal Code: | 07950 |
Phone Number: | 8883247980 |
Fax Number: | 9736951047 |
NPI Enumeration Date: | 04/15/2014 |
NPI Last Update Date: | 04/15/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | 25MA08040300 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |