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General NPI Number Information
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NPI Number | 1598062796
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Entity Type | Organization
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Legal Business Name | ALLA KATSEVA,MD,LLC
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Dates
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Enumeration Date | 02/24/2011
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Last Update Date | 10/30/2023
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Provider Practice Location Address
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Address Line | 561 CRANBURY RD SUITE M
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-5400
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Country | US
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Telephone | 732-238-8200
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Fax | 732-651-6500
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Provider Business Mailing Address
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Address Line | PO BOX 58
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City | EAST BRUNSWICK
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State | NJ
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Zip | 08816-0058
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Country | US
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Telephone | 732-238-8200
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Fax | 732-651-6500
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ALLA KATSEVA
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Credential | M.D.
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Telephone | 732-238-8200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 25 MA07544800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 25MA07544800
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License Number State | NJ
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