Provider Demographics
NPI:1003249087
Name:ATLANTIC ONCOLOGY ASSOCIATES, LLC
Entity type:Organization
Organization Name:ATLANTIC ONCOLOGY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:NASSER
Authorized Official - Middle Name:
Authorized Official - Last Name:BORAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:609-404-9966
Mailing Address - Street 1:54 W JIMMIE LEEDS RD
Mailing Address - Street 2:SUITE 11
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-9438
Mailing Address - Country:US
Mailing Address - Phone:609-404-9966
Mailing Address - Fax:609-404-9967
Practice Address - Street 1:54 W JIMMIE LEEDS RD
Practice Address - Street 2:SUITE 11
Practice Address - City:GALLOWAY
Practice Address - State:NJ
Practice Address - Zip Code:08205-9438
Practice Address - Country:US
Practice Address - Phone:609-404-9966
Practice Address - Fax:609-404-9967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-14
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty