| Osteopathic Medical Care Center | |
|
39-40 Broadway Fair Lawn NJ 07410-5419 | |
| (201) 475-5006 | |
| (201) 475-5009 |
| Full Name | Osteopathic Medical Care Center |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 39-40 Broadway, Fair Lawn, New Jersey |
| Authorized Official Name and Position | Aleksandr Martirosov (DO) |
| Authorized Official Contact | 2014755006 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Osteopathic Medical Care Center 39-40 Broadway Fair Lawn NJ 07410-5419 Ph: (201) 475-5006 | Osteopathic Medical Care Center 39-40 Broadway Fair Lawn NJ 07410-5419 Ph: (201) 475-5006 |
| NPI Number | 1730363250 |
|---|---|
| Provider Enumeration Date | 12/19/2007 |
| Last Update Date | 12/19/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730363250 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 25MB06860100 (New Jersey) | Primary |
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