Provider Demographics
NPI:1518446822
Name:ADVANCED SURGICAL TREATMENT CENTER, LLC
Entity Type:Organization
Organization Name:ADVANCED SURGICAL TREATMENT CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEPIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-223-2873
Mailing Address - Street 1:2420 HIGHWAY 34
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-1808
Mailing Address - Country:US
Mailing Address - Phone:732-223-2873
Mailing Address - Fax:732-223-0868
Practice Address - Street 1:2420 HIGHWAY 34
Practice Address - Street 2:
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1808
Practice Address - Country:US
Practice Address - Phone:732-223-2873
Practice Address - Fax:732-223-0868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical