Provider Demographics
NPI:1417294067
Name:ADVANCED BARIATRIC CENTERS OF NJ
Entity Type:Organization
Organization Name:ADVANCED BARIATRIC CENTERS OF NJ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:D
Authorized Official - Last Name:ABKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-229-9267
Mailing Address - Street 1:229 MOUNTAINSIDE RD
Mailing Address - Street 2:
Mailing Address - City:MENDHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07945-1100
Mailing Address - Country:US
Mailing Address - Phone:973-229-9267
Mailing Address - Fax:
Practice Address - Street 1:229 MOUNTAINSIDE RD
Practice Address - Street 2:
Practice Address - City:MENDHAM
Practice Address - State:NJ
Practice Address - Zip Code:07945-1100
Practice Address - Country:US
Practice Address - Phone:973-229-9267
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-15
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06365800208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty