Provider Demographics
NPI:1841353737
Name:ADVANCED LAPAROSCOPIC ASSOCIATES
Entity type:Organization
Organization Name:ADVANCED LAPAROSCOPIC ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:CONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-646-1121
Mailing Address - Street 1:81 E RTE 4
Mailing Address - Street 2:35 PLAZA PROFESSIONAL CENTER, SUITE 401
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-2634
Mailing Address - Country:US
Mailing Address - Phone:201-646-1121
Mailing Address - Fax:201-646-1110
Practice Address - Street 1:81RTE. 4W.
Practice Address - Street 2:35 PLAZA PROFESSIONAL CENTER, SUITE 401
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-0058
Practice Address - Country:US
Practice Address - Phone:201-646-1121
Practice Address - Fax:201-646-1110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1235299488OtherNPI NUMBER
NJH28958Medicare UPIN
NJF71217Medicare UPIN
NJH92387Medicare UPIN