Provider Demographics
NPI:1356440424
Name:ALLIANCE MEDICAL SPECIALISTS
Entity Type:Organization
Organization Name:ALLIANCE MEDICAL SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SANGASTIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-267-7950
Mailing Address - Street 1:174 SHENANDOAH BLVD
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2941
Mailing Address - Country:US
Mailing Address - Phone:732-267-7950
Mailing Address - Fax:732-929-1330
Practice Address - Street 1:174 SHENANDOAH BLVD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2941
Practice Address - Country:US
Practice Address - Phone:732-267-7950
Practice Address - Fax:732-929-1330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ611060000OtherDEPARTMENT OF LABOR