Provider Demographics
NPI:1184384034
Name:VANGUARD PARTNER NETWORK LLC
Entity type:Organization
Organization Name:VANGUARD PARTNER NETWORK LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:CARRAZZONE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-559-3701
Mailing Address - Street 1:271 GROVE AVE STE E
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:NJ
Mailing Address - Zip Code:07044-1730
Mailing Address - Country:US
Mailing Address - Phone:973-559-3700
Mailing Address - Fax:833-484-1686
Practice Address - Street 1:271 GROVE AVE STE A
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:NJ
Practice Address - Zip Code:07044-1731
Practice Address - Country:US
Practice Address - Phone:973-559-3700
Practice Address - Fax:973-559-8650
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VANGUARD HEALTH SOLUTIONS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-20
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty