| Advanced Digestive Center, Inc | |
|
205 Bridge St Metuchen NJ 08840-2290 | |
| (732) 205-9886 | |
| (732) 205-9887 |
| Full Name | Advanced Digestive Center, Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 205 Bridge St, Metuchen, New Jersey |
| Authorized Official Name and Position | Srinivas S Vasireddi (OWNER) |
| Authorized Official Contact | 7322059886 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Digestive Center, Inc Po Box 359 Edison NJ 08818-0359 Ph: (732) 205-9886 | Advanced Digestive Center, Inc 205 Bridge St Metuchen NJ 08840-2290 Ph: (732) 205-9886 |
| NPI Number | 1962423053 |
|---|---|
| Provider Enumeration Date | 07/22/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 9436167665 |
|---|---|
| Medicare Enrollment ID | O20060330000249 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962423053 | NPI | - | NPPES |
| 7482507 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | 25MA06689300 (New Jersey) | Primary |
| Provider Name | Srinivas S Vasireddi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1417986167 PECOS PAC ID: 8325056559 Enrollment ID: I20060331000010 |
| Provider Name | Haig Minassian |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1114986940 PECOS PAC ID: 7618954322 Enrollment ID: I20091015000099 |
| Provider Name | Umberto Coletta |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1437218641 PECOS PAC ID: 7113115536 Enrollment ID: I20101229000041 |
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