| Astra Md P C | |
|
550 Bloomfield Ave Newark NJ 07107-1386 | |
| (973) 483-1500 | |
| Not Available |
| Full Name | Astra Md P C |
|---|---|
| Speciality | Internal Medicine |
| Location | 550 Bloomfield Ave, Newark, New Jersey |
| Authorized Official Name and Position | Natasha Fuksina (PRESIDENT) |
| Authorized Official Contact | 9734831500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Astra Md P C 550 Bloomfield Ave Newark NJ 07107-1386 Ph: (973) 483-1500 | Astra Md P C 550 Bloomfield Ave Newark NJ 07107-1386 Ph: (973) 483-1500 |
| NPI Number | 1841528080 |
|---|---|
| Provider Enumeration Date | 11/30/2009 |
| Last Update Date | 06/30/2011 |
| Medicare PECOS PAC ID | 7012185713 |
|---|---|
| Medicare Enrollment ID | O20110725000449 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841528080 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 25MA07003100 (New Jersey) | Primary |
| 207UN0901X | Nuclear Medicine - Nuclear Cardiology | 25MA07840500 (New Jersey) | Secondary |
| Provider Name | Natasha Fuksina |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053398065 PECOS PAC ID: 7315932258 Enrollment ID: I20051227000012 |
| Provider Name | Mark Theodore Olesnicky |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770503617 PECOS PAC ID: 8820113442 Enrollment ID: I20100920000119 |
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