Healthcare Provider Details

I. General information

NPI: 1861780173
Provider Name (Legal Business Name): RUSLAN ZHURAVSKY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: RUSSELL ZHURAVSKY DO

II. Dates (important events)

Enumeration Date: 07/20/2011
Last Update Date: 01/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 HWY 9 STE 107
HOWELL NJ
07731-3301
US

IV. Provider business mailing address

1001 HWY 9 STE 107
HOWELL NJ
07731-3301
US

V. Phone/Fax

Practice location:
  • Phone: 732-851-1231
  • Fax: 732-851-1131
Mailing address:
  • Phone: 732-851-1231
  • Fax: 732-851-1131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number25MB09845000
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number285291-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: