Provider Demographics
NPI:1194922161
Name:ADVANCED LAPAROSCOPIC SURGERY INSTITUTE, PC
Entity type:Organization
Organization Name:ADVANCED LAPAROSCOPIC SURGERY INSTITUTE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:AJAY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOYAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-481-1270
Mailing Address - Street 1:193 MORRIS AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-1211
Mailing Address - Country:US
Mailing Address - Phone:908-481-1270
Mailing Address - Fax:908-688-8861
Practice Address - Street 1:193 MORRIS AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1211
Practice Address - Country:US
Practice Address - Phone:908-481-1270
Practice Address - Fax:908-688-8861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07495000208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty