Organization Active NPI

Endometriosis and Advanced Pelvic Surgical Specialists, LLC

  • Gynecology Physician
  • South Orange, NJ
National Provider Identifier
1053187088
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
ENDOMETRIOSIS AND ADVANCED PELVIC SURGICAL SPECIALISTS, LLC
Practice address
4 S Orange Ave Ste 254
South Orange, NJ 07079-1702
Phone
(201) 793-7999
Fax
(212) 717-6130
NPI assigned
Nov 30, 2023
Last updated
Nov 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Lora Liu
Title
MD
Phone
(201) 793-7999

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X NU Primary

Addresses

Primary practice location

4 S Orange Ave Ste 254
South Orange, NJ 07079-1702

Mailing address

4 S Orange Ave Ste 254
South Orange, NJ 07079-1702
Phone (201) 793-7999

National Provider Directory

National Provider Directory

Locations

4 S Orange Ave
South Orange, NJ 07079
Phone (646) 849-3549

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1053187088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 S ORANGE AVE STE 254",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070791702",
            "telephone_number": "201-793-7999",
            "fax_number": "212-717-6130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 S ORANGE AVE STE 254",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070791702",
            "telephone_number": "201-793-7999",
            "fax_number": "212-717-6130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOMETRIOSIS AND ADVANCED PELVIC SURGICAL SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-28",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "LORA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "201-793-7999"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Orange, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.