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General NPI Number Information
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NPI Number | 1356570774
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Entity Type | Organization
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Legal Business Name | CENTER FOR HOLISTIC & INTEGRATIVE MEDICINE
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Dates
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Enumeration Date | 07/07/2009
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Last Update Date | 07/07/2009
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Provider Practice Location Address
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Address Line | 60 GRAND AVE
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-6583
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Country | US
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Telephone | 201-294-8405
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Fax |
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Provider Business Mailing Address
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Address Line | 60 GRAND AVE
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City | ENGLEWOOD
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State | NJ
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Zip | 07631-6583
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Country | US
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Telephone | 201-294-8405
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Fax |
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Authorized Official
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Title or Position | DIRECTOR, INTERNIST
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Name | DR. ANNALISA PASTORE
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Credential | MD
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Telephone | 201-294-8405
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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 | 25MA08471600
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License Number State | NJ
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