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Organization

ADVANTAGE SPORTS MEDICINE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
THOMAS S BOTTIGLIERI D.O. (OWNER/PHYSICIAN)
(201) 569-0010
Entity
Organization

Contact information

Practice address
67 BROADWAY, ELMWOOD PARK, NJ 07407-1836
(201) 569-0010
Mailing address
PO BOX 70176, STATEN ISLAND, NY 10307-0176
(718) 984-4094

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
25 MB07982100
NJ

Other

Enumeration date
10/01/2013
Last updated
01/21/2014
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