Healthcare Provider Details

I. General information

NPI: 1982739793
Provider Name (Legal Business Name): STERLING SURGICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 04/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 CLAYHOLE RD
LITTLE EGG HARBOR TWP NJ
08087-2109
US

IV. Provider business mailing address

5 CLAYHOLE RD
LITTLE EGG HARBOR TWP NJ
08087-2109
US

V. Phone/Fax

Practice location:
  • Phone: 609-296-5784
  • Fax: 609-296-5784
Mailing address:
  • Phone: 609-296-5784
  • Fax: 609-296-5784

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number26NJ00054900
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number26NJ00054900
License Number StateNJ
# 3
Primary TaxonomyY
Taxonomy Code364SP2800X
TaxonomyPerioperative Clinical Nurse Specialist
License Number26NJ00054900
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number26NO06959300
License Number StateNJ

VIII. Authorized Official

Name: LAURIE J. DIDYK
Title or Position: PRESIDENT
Credential: MSN APN
Phone: 609-286-5794