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NPI 1063972107

NPI 1063972107 : ROSS FIRESTONE MD, PHD : MONTVALE, NJ

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General NPI Number Information
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    NPI Number           |    1063972107
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    Entity Type          |    Individual 
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    Provider Name        |    ROSS FIRESTONE MD, PHD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/24/2019
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    Last Update Date     |    05/13/2025
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Provider Practice Location Address
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    Address Line         |    225 SUMMIT AVE 
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    City                 |    MONTVALE
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    State                |    NJ
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    Zip                  |    07645-1523
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    Country              |    US
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    Telephone            |    201-775-7000
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    225 SUMMIT AVE 
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    City                 |    MONTVALE
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    State                |    NJ
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    Zip                  |    07645-1523
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    Country              |    US
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    Telephone            |    201-775-7000
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207RH0003X
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    Taxonomy Name        |    Hematology & Oncology Physician
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    License Number       |    307320
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    License Number State |    NY
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