Provider Demographics
NPI:1336489913
Name:ADVANCED SURGICAL RADIOLOGY LLC
Entity Type:Organization
Organization Name:ADVANCED SURGICAL RADIOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CURRERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-640-5316
Mailing Address - Street 1:49 VERONICA AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-6802
Mailing Address - Country:US
Mailing Address - Phone:732-640-5316
Mailing Address - Fax:800-689-2361
Practice Address - Street 1:49 VERONICA AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-6802
Practice Address - Country:US
Practice Address - Phone:732-640-5316
Practice Address - Fax:800-689-2361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-19
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA079175002085U0001X
208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty