Provider Demographics
NPI:1669893889
Name:GENERAL VASCULAR SURGICAL SPECIALISTS LLC
Entity type:Organization
Organization Name:GENERAL VASCULAR SURGICAL SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:S
Authorized Official - Last Name:PILLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-848-8242
Mailing Address - Street 1:17 W RED BANK AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:WOODBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:08096-1630
Mailing Address - Country:US
Mailing Address - Phone:856-848-8242
Mailing Address - Fax:856-384-6015
Practice Address - Street 1:17 W RED BANK AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:WOODBURY
Practice Address - State:NJ
Practice Address - Zip Code:08096-1630
Practice Address - Country:US
Practice Address - Phone:856-848-8242
Practice Address - Fax:856-384-6015
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INSPIRA HEALTH NETWORK MEDICAL GROUP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty