Provider Demographics
NPI:1790206563
Name:BARIATRIC SURGICAL ASSOCIATES LLC
Entity Type:Organization
Organization Name:BARIATRIC SURGICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMIN
Authorized Official - Prefix:MS
Authorized Official - First Name:GABRIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CURRERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-640-5316
Mailing Address - Street 1:81 VERONICA AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-3491
Mailing Address - Country:US
Mailing Address - Phone:732-640-5316
Mailing Address - Fax:888-511-1202
Practice Address - Street 1:81 VERONICA AVE STE 205
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-3491
Practice Address - Country:US
Practice Address - Phone:732-640-5316
Practice Address - Fax:888-511-1202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-03
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07917500208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA07917500OtherSTATE OF NJ