Advanced Medical Supply

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

License

40QA01350900 Issued in NJ

Legal business name

ADVANCED MEDICAL SUPPLY

Practice address

20 Country Club LN
Colts Neck, NJ 07722-2222

Phone

(908) 670-7573

Fax

(855) 678-8887

NPI assigned

Jan 23, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Daniel Reizis, PT, DPTNPI 1174835755

Title

Managing Member

Phone

(908) 670-7573

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Daniel Reizis, PT

  • Physical Therapist
  • Colts Neck, NJ
  • NPI 1174835755
  NPD (past) Authorized official

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

{
    "created_epoch": "1358899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1467790634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 COUNTRY CLUB LN",
            "city": "COLTS NECK",
            "state": "NJ",
            "postal_code": "077222222",
            "telephone_number": "908-670-7573",
            "fax_number": "855-678-8887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 COUNTRY CLUB LN",
            "city": "COLTS NECK",
            "state": "NJ",
            "postal_code": "077222222",
            "telephone_number": "908-670-7573",
            "fax_number": "855-678-8887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MEDICAL SUPPLY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-23",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "REIZIS",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "908-670-7573",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "NJ",
            "license": "40QA01350900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Subina Anand, DMD
• Philip Joseph Angello, M.D.
• George Asfendis, PSY.D.
• Autism Harmony Inc

• Customized Equipment (DME) in Colts Neck, NJ
• Providers in Colts Neck, NJ by specialty
• Customized Equipment (DME) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 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.