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NPI Code Detail

MEDICARE: DR. ALEXANDER M VITIEVSKY M.D.

MEDICARE: DR. ALEXANDER M VITIEVSKY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RN0300XNephrology PhysicianMA07249700NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1447250303
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALEXANDER M VITIEVSKY M.D.
Provider Business Mailing Address
First Line : 302 UNION ST
Second Line :
City : HACKENSACK
State : NJ
Zip : 07601-4303
Country : US
Telephone Number : 201-646-0414
Fax Number : 201-646-0365
Provider Business Practice Location Address
First Line : 718 TEANECK RD
Second Line :
City : TEANECK
State : NJ
Zip : 07666-4245
Country : US
Telephone Number : 201-833-3223
Fax Number : 201-833-7090
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2005
Last Update Date : 02/11/2008

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