Advanced Laparoscopic Surgical Specialists
Organization Active NPI Specialist · Bardonia, NY
NPI 1215079587 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1215079587
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- 232695 (NY)
- Legal business name
- ADVANCED LAPAROSCOPIC SURGICAL SPECIALISTS
- Practice address
- 445 Route 304
Bardonia, NY 10954-1614 - Phone
- (845) 624-4425
- Fax
- (845) 624-4428
- NPI assigned
- Feb 13, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Esther Marie Kempf
- Title
- Medical Secretary
- Phone
- (845) 624-4425
Practitioners 1
-
Richard A Pucci, D.O.
National Provider Directory
Locations
445 Route 304
Nanuet, NY 10954
Phone (845) 624-2929
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | 232695 | NY | Yes |
Addresses
Primary practice location
445 Route 304
Bardonia, NY 10954-1614
Mailing address
445 Route 304
Bardonia, NY 10954-1614
Phone (845) 624-4425
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2601545 | Medicaid | NY |
Other providers in Bardonia, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.