Provider Demographics
NPI:1497743819
Name:ADVANCED VASCULAR ASSOCIATES, PC
Entity Type:Organization
Organization Name:ADVANCED VASCULAR ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMIT
Authorized Official - Middle Name:V
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-540-9700
Mailing Address - Street 1:131 MADISON AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-7360
Mailing Address - Country:US
Mailing Address - Phone:973-540-9700
Mailing Address - Fax:973-540-9717
Practice Address - Street 1:131 MADISON AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-7360
Practice Address - Country:US
Practice Address - Phone:973-540-9700
Practice Address - Fax:973-540-9717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA606082086S0129X
NJMA609382086S0129X
NJMA588052086S0129X
NJMA741882086S0129X
NJMA805422086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ8123306Medicaid
NJ8123306Medicaid