Organization
NORTHERN VALLEY ID, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAN KO (PRESIDENT)
(201) 408-5314
Entity
Organization
Contact information
Practice address
400 SYLVAN AVE STE 108, ENGLEWOOD CLIFFS, NJ 07632-2717
(201) 408-5314
Mailing address
400 SYLVAN AVE STE 108, ENGLEWOOD CLIFFS, NJ 07632-2717
(201) 408-5314
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Enumeration date
11/06/2018
Last updated
11/06/2018
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