Natalya Avanesova Llc | |
193 Route 9 Ste 1d Manalapan NJ 07726-3016 | |
(732) 677-2505 | |
(732) 677-2506 |
Full Name | Natalya Avanesova Llc |
---|---|
Speciality | Internal Medicine |
Location | 193 Route 9 Ste 1d, Manalapan, New Jersey |
Authorized Official Name and Position | Natalya Oleg Avanesova (OWNER) |
Authorized Official Contact | 7326772505 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Natalya Avanesova Llc 193 Route 9 South, Suite 1d Manalapan NJ 07726-3016 Ph: (732) 677-2505 | Natalya Avanesova Llc 193 Route 9 Ste 1d Manalapan NJ 07726-3016 Ph: (732) 677-2505 |
NPI Number | 1578797759 |
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Provider Enumeration Date | 05/04/2009 |
Last Update Date | 07/07/2023 |
Medicare PECOS PAC ID | 9335290014 |
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Medicare Enrollment ID | O20090622000029 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578797759 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
Provider Name | Natalya O Avanesova |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1902891583 PECOS PAC ID: 1557359460 Enrollment ID: I20040430001133 |
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