Healthcare Provider Details

I. General information

NPI: 1730133794
Provider Name (Legal Business Name): DRS FRIEDRICH RUBIN PANELLA AND SAPIENZA, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 06/13/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 GRAND AVE
ENGLEWOOD NJ
07631-4152
US

IV. Provider business mailing address

420 GRAND AVE SUITE 101
ENGLEWOOD NJ
07631-4152
US

V. Phone/Fax

Practice location:
  • Phone: 201-569-7044
  • Fax: 201-569-1999
Mailing address:
  • Phone: 201-569-7044
  • Fax: 201-569-1999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NATASHA MOHAMMED
Title or Position: OFFICE ADMINISTRATOR
Credential:
Phone: 201-569-7044