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General NPI Number Information
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NPI Number | 1780014415
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Entity Type | Organization
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Legal Business Name | CLIFTON MEDICAL PAIN & REHABILITATION CENTER
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Dates
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Enumeration Date | 11/15/2013
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Last Update Date | 11/15/2013
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Provider Practice Location Address
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Address Line | 505 LEXINGTON AVE
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City | CLIFTON
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State | NJ
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Zip | 07011-1935
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Country | US
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Telephone | 973-928-2542
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Fax | 973-928-2544
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Provider Business Mailing Address
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Address Line | 505 LEXINGTON AVE
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City | CLIFTON
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State | NJ
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Zip | 07011-1935
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Country | US
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Telephone | 973-928-2542
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Fax | 973-928-2544
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Authorized Official
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Title or Position | M.D.
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Name | NABIL M YAZGI
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Credential | M.D.
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Telephone | 973-928-2542
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 25MA04538400
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License Number State | NJ
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