Organization Name: | PREMIER SURGICAL SERVICES, P.C. |
NPI Number: | 1093995193 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RANDALL VICTOR EHRLICH (PRESIDENT) |
Mailing Address: | 68 Boulder Ridge Rd Scarsdale |
State: | NY US |
Postal Code: | 105833150 |
Phone Number: | 8778778232 |
Fax Number: | 8778778232 |
NPI Enumeration Date: | 11/06/2007 |
NPI Last Update Date: | 03/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | 198606 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |