Organization
SHORE SURGICAL ASSISTANT SERVICE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY A BUCK CRNFA (OWNER)
(609) 476-4624
Entity
Organization
Contact information
Practice address
62 TUCKAHOE RD, DOROTHY, NJ 08317-9702
(609) 476-4624
Mailing address
PO BOX 331, MAYS LANDING, NJ 08330-0331
(973) 957-0551
(866) 396-3054
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
26NO09467800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SSN
NJ
Enumeration date
04/09/2007
Last updated
05/21/2020
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