# IGOR M POVZHITKOV M D P C

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801087572
- **Authorized official:** DR. IGOR M POVZHITKOV M.D. (PRESIDENT)
- **Authorized official phone:** (201) 218-6439

## Contact information

- **Practice address:** 343 ELLEN PL, PARAMUS, NJ 07652-5506
- **Practice address phone:** (201) 218-6439
- **Mailing address:** 343 ELLEN PL, PARAMUS, NJ 07652-5506
- **Mailing address phone:** (201) 218-6439

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | 23278 | NJ | Yes |

## Other

- **Enumeration date:** 08/07/2007
- **Last updated:** 08/08/2007