Healthcare Provider Details

I. General information

NPI: 1730060104
Provider Name (Legal Business Name): CILIN PHILIP SURGICAL ASSIST LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2025
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 WASON AVE
SPRINGFIELD MA
01107-1274
US

IV. Provider business mailing address

2218 RIVERVIEW AVE
ENGLEWOOD NJ
07631-8719
US

V. Phone/Fax

Practice location:
  • Phone: 413-286-1020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: MR. CILIN PHILIP
Title or Position: MANAGER
Credential: PA
Phone: 914-513-9291