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Individual

CYRUS VOSOUGH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
504 HAMBURG TPKE STE B105, WAYNE, NJ 07470-2011
(973) 595-0063
(973) 240-8990
Mailing address
PO BOX 43092, UPPER MONTCLAIR, NJ 07043-0092
(973) 595-0063
(973) 720-0408

Taxonomy

Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
MA070629
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
8481008
NJ
Enumeration date
06/02/2005
Last updated
02/24/2021
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