Individual
DR. TATIANA KRASIKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2200 FLETCHER AVENUE, FORT LEE, NJ 07024
(201) 461-6200
(201) 461-7204
Mailing address
2200 FLETCHER AVENUE, FORT LEE, NJ 07024
(201) 461-6200
(201) 461-7204
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
224090
NY
174400000X
Specialist
25MA08253200
NJ
207RC0000X
Cardiovascular Disease Physician
Primary
25MA08253200
NJ
Other
Enumeration date
01/26/2007
Last updated
09/06/2017
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