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Organization

INTRA-OP FIRST ASSIST SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PHILLIP D ROSE PA-C (OWNER)
(201) 357-5468
Entity
Organization

Contact information

Practice address
492 CEDAR LN BLDG C, #340, TEANECK, NJ 07666-1713
(201) 357-5468
Mailing address
492 CEDAR LN BLDG C, #340, TEANECK, NJ 07666-1713

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
25MP00182600
NJ

Other

Enumeration date
04/14/2015
Last updated
04/14/2015
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