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General NPI Number Information
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NPI Number | 1700924669
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Entity Type | Individual
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Provider Name | IGOR M POVZHITKOV M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 07/15/2010
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Provider Practice Location Address
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Address Line | 520 SYLVAN AVE 1ST FLOOR
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City | ENGLEWOOD CLIFFS
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State | NJ
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Zip | 07632-3022
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Country | US
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Telephone | 201-816-1991
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Fax | 201-632-6403
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Provider Business Mailing Address
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Address Line | 343 ELLEN PL
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City | PARAMUS
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State | NJ
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Zip | 07652-5506
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Country | US
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Telephone | 201-218-6439
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Fax | 201-632-6403
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 25MA07341800
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 216770-1
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 25MA07341800
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License Number State | NJ
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