Provider Demographics
NPI:1437313517
Name:THE CENTER FOR ADVANCED TREATMENT OF DIGESTIVE AND LIVER DISEASES, LLC
Entity Type:Organization
Organization Name:THE CENTER FOR ADVANCED TREATMENT OF DIGESTIVE AND LIVER DISEASES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:
Authorized Official - Last Name:FIORITO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-851-2770
Mailing Address - Street 1:1308 MORRIS AVE
Mailing Address - Street 2:SUITE102
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-3331
Mailing Address - Country:US
Mailing Address - Phone:908-851-2770
Mailing Address - Fax:908-851-9023
Practice Address - Street 1:1308 MORRIS AVE
Practice Address - Street 2:SUITE102
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-3331
Practice Address - Country:US
Practice Address - Phone:908-851-2770
Practice Address - Fax:908-851-9023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07250700207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherNONE