ADVANTAGE SPORTS MEDICINE LLC (NPI# 1922435395) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922435395 |
| Entity Type | Organization |
| Organization Name | ADVANTAGE SPORTS MEDICINE LLC |
| Practice Address |
67 Broadway Elmwood Park NJ 07407-1836 |
| Mailing Address |
Po Box 70176 Staten Island NY 10307-0176 |
| Practice Telephone | 2015690010 |
| Mailing Telephone | 7189844094 |
| Enumeration Date | 2013-10-01 |
| Last Update Date | 2014-01-21 |
| Authorized Official Name | THOMAS S BOTTIGLIERI (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 2015690010 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
25 MB07982100 | NJ | Ambulatory Health Care Facilities |
| Street Address |
67 BROADWAY |
| City | ELMWOOD PARK |
| State | NJ |
| Zip Code | 07407-1836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487614467 | Ralph C. Napoli | Podiatrist | 67 Broadway, Elmwood Park, NJ 07407-1836 | 2006-03-24 |
| 1285091728 | Active Orthopedics & Sports Medicine LLC | Orthopaedic Surgery | 67 Broadway, Elmwood Park, NJ 07407-1836 | 2016-01-27 |
| 1043457211 | Professional Sports Medicine Associates L.l.c | Family Medicine | 67 Broadway, Elmwood Park, NJ 07407-1836 | 2009-01-09 |
| 1619188414 | Bart E. Maggio & Peter K. Finelli | Family Medicine | 67 Broadway, Elmwood Park, NJ 07407-1836 | 2007-05-24 |
| 1326182346 | Bergen Family Foot Care, LLC | Podiatrist | 67 Broadway, Elmwood Park, NJ 07407-1836 | 2007-02-16 |
| 1427067156 | Peter K. Finelli | Family Medicine | 67 Broadway, Elmwood Park, NJ 07407-1836 | 2006-08-05 |
| 1033140736 | Pritee Shah | Physical Therapist | 67 Broadway, Broadway Foot and Ankle Ctr., Pa, Elmwood Park, NJ 07407 | 2006-07-05 |
| 1609806843 | Dixit Dinesh Patel | Podiatrist | 67 Broadway, Elmwood Park, NJ 07407-1836 | 2006-07-04 |
| 1518996503 | Active Physical Therapy Inst., Pa | Clinic/Center | 67 Broadway, Elmwood Park, NJ 07407 | 2006-07-02 |
| 1518908474 | Pasko L Gazivoda | Podiatrist | 67 Broadway, Elmwood Park, NJ 07407-1836 | 2006-06-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063042406 | Diana Marie Monteleon | Registered Nurse | 75 Miller Avenue, Elmwood Park, NJ 07407 | 2020-01-24 |
| 1427569102 | Fastcare Medical Transportation | Ambulance | 62 Philip Ave, Elmwood, NJ 07407 | 2017-10-20 |
| 1376078642 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 59 Boulevard, Elmwood Village Apartments, Elmwood Park, NJ 07407 | 2017-04-25 |
| 1457885048 | The Devereux Foundation | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 111 Donor Avenue, Apt A, Elmwood Park, NJ 07407 | 2017-04-20 |
| 1295143196 | Juan Quesada | Student in an Organized Health Care Education/Training Program | 21 Craig Court, Elmwood Park, NJ 07407 | 2014-07-24 |
| 1548546492 | Pinnacle Mri Group, LLC | Clinic/Center | 97 Linden Avenue, Elmwood Park, NJ 07407 | 2011-10-24 |
| 1598914921 | Aaron David Brisman | Dentist | 511 River Drive, Elmwood Park, NJ 07407 | 2008-09-10 |
| 1922267004 | Borough of Elmwood Park | Public Health or Welfare | 182 Market Street, Health Department, Elmwood Park, NJ 07407 | 2008-06-04 |
| 1043477599 | Deborah W. Buzaid | Pathology | 481 Edward H. Ross Drive, Elmwood Park, NJ 07407 | 2008-05-21 |
| 1558571828 | Yan Gao Fan | Pathology | 481 Edward H Ross Drive, Elmwood Park, NJ 07407 | 2007-05-23 |
| Find all providers in zip 07407 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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|---|---|---|---|---|
| 1902852460 | Resurrection Services | Clinic/Center | 7230 W North Ave, Ste 106b Resurrection Immediate Care Center Elmwood Par, Elmwood Park, IL 60707-4262 | 2006-05-26 |
| 1407182108 | Presence Ambulatory Services | Clinic/Center | 7230 W North Ave, Suite 106b, Elmwood Park, IL 60707-4261 | 2009-10-30 |
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| 1407409360 | Mordecai & Caravello Wellness, LLC | Clinic/Center | 1401 Marlton Pike E Ste 14, Cherry Hill, NJ 08034-2207 | 2019-07-19 |
| 1942767066 | Carerivet Medical Services LLC | Clinic/Center | 26 University Place Blvd, 1st Floor, Jersey City, NJ 07305 | 2019-02-25 |
| 1275097255 | Health Check of Nj LLC | Clinic/Center | 160 Lanza Ave Ste 8, Garfield, NJ 07026-3551 | 2019-01-24 |
| 1164996591 | Comprehensive Medical Associates of New Jersey P C | Clinic/Center | 1000 Harbor Blvd, Weehawken, NJ 07086-6761 | 2019-01-18 |
| 1578036968 | Acupuncture Eden & Wellness Center | Clinic/Center | 221 Sherman Ave Ste A, Berkeley Heights, NJ 07922-1173 | 2019-01-08 |
| Find all providers with the same taxonomy | ||||
| City | ELMWOOD PARK |
| Zip Code | 07407 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.