Provider Demographics
NPI:1477211381
Name:ADVANCE HEALTHCARE ASSOCIATES LLC
Entity Type:Organization
Organization Name:ADVANCE HEALTHCARE ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ASSEMU
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:848-200-3009
Mailing Address - Street 1:1806 HWY 35 STE 102
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-2766
Mailing Address - Country:US
Mailing Address - Phone:848-200-3009
Mailing Address - Fax:833-795-1978
Practice Address - Street 1:1806 HWY 35 STE 102
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-2766
Practice Address - Country:US
Practice Address - Phone:848-200-3009
Practice Address - Fax:833-795-1978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-08
Last Update Date:2022-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1639589880OtherCMS
NJ1558923995OtherCMS