Provider Demographics
NPI:1609062165
Name:ANTHONY J VASSELLI, MD PC
Entity Type:Organization
Organization Name:ANTHONY J VASSELLI, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:J
Authorized Official - Last Name:VASSELLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-252-0575
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA44032208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ053660Medicare PIN