Organization
SHORE SURGICAL ASSISTING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONN M HOOSACK PA-C (OWNER)
(732) 236-1104
Entity
Organization
Contact information
Practice address
1070 CLEARWATER AVE, MANAHAWKIN, NJ 08050-2303
(732) 236-1104
(609) 978-2750
Mailing address
1070 CLEARWATER AVE, MANAHAWKIN, NJ 08050-2303
(732) 236-1104
(609) 978-2750
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
25MP00132300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MP00132300
PHYSICIAN ASSISTANT LICENSE
NJ
01
—
A00006300
CDS
NJ
Enumeration date
04/24/2012
Last updated
03/07/2023
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