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General NPI Number Information
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NPI Number | 1235429911
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Entity Type | Organization
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Legal Business Name | ANNA J. LAVOTSHKIN, MD, PC
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Dates
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Enumeration Date | 04/14/2011
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Last Update Date | 04/18/2011
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Provider Practice Location Address
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Address Line | 757 TEANECK RD
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City | TEANECK
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State | NJ
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Zip | 07666-4241
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Country | US
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Telephone | 201-833-2288
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Fax | 201-833-4441
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Provider Business Mailing Address
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Address Line | 757 TEANECK RD
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City | TEANECK
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State | NJ
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Zip | 07666-4241
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Country | US
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Telephone | 201-833-2288
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Fax | 201-833-4441
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. RAISA SALTANOVICH
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Credential |
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Telephone | 201-833-2288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 54741MA
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License Number State | NJ
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