Provider Demographics
NPI:1396921383
Name:ADVANCED ASSIST, LLC
Entity type:Organization
Organization Name:ADVANCED ASSIST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APN
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BERNARDINI
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:856-776-3295
Mailing Address - Street 1:PO BOX 1522
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332-8522
Mailing Address - Country:US
Mailing Address - Phone:856-776-3295
Mailing Address - Fax:
Practice Address - Street 1:994 W SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-6937
Practice Address - Country:US
Practice Address - Phone:856-696-0900
Practice Address - Fax:973-648-3481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-21
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00135000363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty