Organization
ALLI SURGICAL ASSOCIATES,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PADMAVATHY ALLI DO (PRESIDENT)
(973) 429-9844
Entity
Organization
Contact information
Practice address
557 BROAD ST, SUITE # 22, BLOOMFIELD, NJ 07003-2885
(973) 429-9844
(973) 429-9858
Mailing address
21 BAKLEY TER, WEST ORANGE, NJ 07052-2169
(973) 429-9844
(973) 429-9858
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MB063954
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7045301
—
NJ
Enumeration date
05/18/2012
Last updated
05/18/2012
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