Healthcare Provider Details

I. General information

NPI: 1205224235
Provider Name (Legal Business Name): SAINT PETER'S ADVANCED CARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2014
Last Update Date: 12/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 EASTON AVE ATTN: MANAGED CARE
NEW BRUNSWICK NJ
08901-1766
US

IV. Provider business mailing address

254 EASTON AVE ATTN: MANAGED CARE
NEW BRUNSWICK NJ
08901-1766
US

V. Phone/Fax

Practice location:
  • Phone: 732-565-5453
  • Fax: 732-249-9572
Mailing address:
  • Phone: 732-565-5453
  • Fax: 732-249-9572

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANTHONY J. PASSANNANTE JR.
Title or Position: PRESIDENT
Credential: MD
Phone: 732-745-8600