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General NPI Number Information
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NPI Number | 1013130210
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Entity Type | Organization
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Legal Business Name | RNFA SURGICAL SERVICES
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 506 WESTERLY DR
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City | MARLTON
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State | NJ
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Zip | 08053-1068
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Country | US
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Telephone | 856-797-9193
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Fax |
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Provider Business Mailing Address
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Address Line | 506 WESTERLY DR
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City | MARLTON
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State | NJ
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Zip | 08053-1068
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Country | US
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Telephone | 856-797-9193
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. SUZANNE LEE ROSTOVSKIS
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Credential |
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Telephone | 856-797-9193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | 26NR02437400
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License Number State | NJ
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