Basic Information
Provider Information
NPI: 1396921383
EntityType: 2
ReplacementNPI:  
OrganizationName: ADVANCED ASSIST, LLC
LastName:  
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Credential:  
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Mailing Information
Address1: PO BOX 1522
Address2:  
City: MILLVILLE
State: NJ
PostalCode: 083328522
CountryCode: US
TelephoneNumber: 8567763295
FaxNumber:  
Practice Location
Address1: 994 W SHERMAN AVE
Address2:  
City: VINELAND
State: NJ
PostalCode: 083606937
CountryCode: US
TelephoneNumber: 8566960900
FaxNumber: 9736483481
Other Information
ProviderEnumerationDate: 01/21/2008
LastUpdateDate: 04/17/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: BERNARDINI
AuthorizedOfficialFirstName: MARIANNE
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AuthorizedOfficialTitleorPosition: APN
AuthorizedOfficialTelephone: 8567763295
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MRS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: APN
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LA2100X26NJ00135000NJY193400000X SINGLE SPECIALTY GROUPPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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