Provider Demographics
NPI:1639060387
Name:HERITAGE SURGICAL PARTNERS, LLC
Entity type:Organization
Organization Name:HERITAGE SURGICAL PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:RADVINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-833-2888
Mailing Address - Street 1:9 POST RD STE M9
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07436-1615
Mailing Address - Country:US
Mailing Address - Phone:201-833-2888
Mailing Address - Fax:201-833-2888
Practice Address - Street 1:9 POST RD STE M9
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:NJ
Practice Address - Zip Code:07436-1615
Practice Address - Country:US
Practice Address - Phone:201-833-2888
Practice Address - Fax:201-833-2888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal SurgeryGroup - Multi-Specialty