Organization
KRETOV MEDICAL ARTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEKSEY KRETOV M.D. (PHYSICIAN)
(732) 414-2005
Entity
Organization
Contact information
Practice address
1806 RTE 35 STE 105, OAKHURST, NJ 07755-2766
(732) 414-2005
(732) 414-2006
Mailing address
1806 RTE 35 STE 105, OAKHURST, NJ 07755-2766
(732) 414-2005
(732) 414-2006
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
25MA08294000
NJ
261QP2300X
Primary Care Clinic/Center
25MA08294000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0166570
—
NJ
Enumeration date
12/27/2007
Last updated
04/21/2023
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