Provider Demographics
NPI:1205224235
Name:SAINT PETER'S ADVANCED CARE, PC
Entity Type:Organization
Organization Name:SAINT PETER'S ADVANCED CARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:PASSANNANTE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:732-745-8600
Mailing Address - Street 1:254 EASTON AVE
Mailing Address - Street 2:ATTN: MANAGED CARE
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-1766
Mailing Address - Country:US
Mailing Address - Phone:732-565-5453
Mailing Address - Fax:732-249-9572
Practice Address - Street 1:254 EASTON AVE
Practice Address - Street 2:ATTN: MANAGED CARE
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-1766
Practice Address - Country:US
Practice Address - Phone:732-565-5453
Practice Address - Fax:732-249-9572
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-29
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty