Provider Demographics
NPI:1235378175
Name:ADVANCED MEDICINE PC
Entity Type:Organization
Organization Name:ADVANCED MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LUDMILA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIDLOVSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-851-4955
Mailing Address - Street 1:21 KILMER DR
Mailing Address - Street 2:BUILDING 2, SUITE A
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1571
Mailing Address - Country:US
Mailing Address - Phone:732-851-4955
Mailing Address - Fax:509-362-9699
Practice Address - Street 1:186 COUNTY ROAD 520 STE 1
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-1246
Practice Address - Country:US
Practice Address - Phone:732-851-4955
Practice Address - Fax:509-362-9699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-17
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25 MA08292400261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care