Healthcare Provider Details

I. General information

NPI: 1720637150
Provider Name (Legal Business Name): CAREMED PLUS P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2019
Last Update Date: 09/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 HAMBURG TPKE STE 107
WAYNE NJ
07470-8482
US

IV. Provider business mailing address

508 HAMBURG TPKE STE 107
WAYNE NJ
07470-8482
US

V. Phone/Fax

Practice location:
  • Phone: 201-297-9517
  • Fax:
Mailing address:
  • Phone: 201-297-9517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ALEXANDER IVANOV
Title or Position: OWNER/OPERATOR
Credential: MD
Phone: 201-297-9517