Healthcare Provider Details

I. General information

NPI: 1992276539
Provider Name (Legal Business Name): ADVANCED THERAPEUTICS OF LI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2018
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 GAZZA BLVD
FARMINGDALE NY
11735-1401
US

IV. Provider business mailing address

141 UNQUA RD
MASSAPEQUA NY
11758-7518
US

V. Phone/Fax

Practice location:
  • Phone: 631-909-6290
  • Fax: 631-759-9212
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: LUKAS WILLIAM PELLIZZI
Title or Position: OWNER, PRESIDENT
Credential:
Phone: 516-695-0875