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General NPI Number Information
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NPI Number | 1427621754
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Entity Type | Organization
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Legal Business Name | ZELS IV INFUSION CENTER LLC
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Dates
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Enumeration Date | 07/23/2021
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Last Update Date | 07/26/2021
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Provider Practice Location Address
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Address Line | 223 TAYLORS MILLS RD
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City | MANALAPAN
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State | NJ
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Zip | 07726-3229
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Country | US
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Telephone | 718-790-0815
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Fax |
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Provider Business Mailing Address
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Address Line | 41 EAGLE RD
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City | MARLBORO
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State | NJ
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Zip | 07746-1810
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Country | US
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Telephone | 718-790-0815
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Fax |
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | MRS. IZOLDA IZMAYLOVA
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Credential | ANP-C
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Telephone | 718-790-0815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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