Organization
TRI STATE HEALTH AND WELLNESS MEDICAL CARE CENTER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEKSANDER MARTIROSOV D.O. (MEDICAL DIRECTRO)
(201) 791-7771
Entity
Organization
Contact information
Practice address
31-00 BROADWAY 1ST FLOOR, FAIR LAWN, NJ 07410
(201) 741-5891
(201) 791-7337
Mailing address
31-00 BROADWAY, FAIR LAWN, NJ 07410-3963
(201) 741-5891
(201) 791-7337
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
25MB06860100
NJ
207QA0401X
Addiction Medicine (Family Medicine) Physician
25MB06860100
NJ
207QA0505X
Adult Medicine Physician
25MB06860100
NJ
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
25MB06860100
NJ
207RA0401X
Addiction Medicine (Internal Medicine) Physician
25MB06860100
NJ
207RC0000X
Cardiovascular Disease Physician
25MB06860100
NJ
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
25MB06860100
NJ
207RI0011X
Interventional Cardiology Physician
25MB06860100
NJ
207RS0010X
Sports Medicine (Internal Medicine) Physician
25MB06860100
NJ
208D00000X
General Practice Physician
Primary
25MB06860100
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7912404
—
NJ
Enumeration date
02/21/2013
Last updated
02/21/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us