Organization
INFECTIOUS DISEASES SERVICES OF NEW JERSEY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKHAIL MOURAVSKI (PRACTICE MANAGER)
(973) 953-6673
Entity
Organization
Contact information
Practice address
511 S ORANGE AVE, SOUTH ORANGE, NJ 07079-2636
(973) 200-3600
(973) 821-3651
Mailing address
511 S ORANGE AVE, SOUTH ORANGE, NJ 07079-2636
(973) 200-3600
(973) 821-3651
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Enumeration date
06/22/2010
Last updated
06/22/2010
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