Provider Demographics
NPI:1578559845
Name:VASSELLI, ANTHONY JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JOSEPH
Last Name:VASSELLI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:299 WITHERSPOON ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08542-3227
Mailing Address - Country:US
Mailing Address - Phone:609-252-0575
Mailing Address - Fax:609-252-0871
Practice Address - Street 1:299 WITHERSPOON ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08542-3227
Practice Address - Country:US
Practice Address - Phone:609-252-0575
Practice Address - Fax:609-252-0871
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-22
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA44032208800000X
CT73445208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ053660Medicare ID - Type Unspecified
NJE61504Medicare UPIN