Organization
TRI-STATE HEALTHY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEKSANDR MARTIROSOV D.O (OWNER)
(201) 791-7771
Entity
Organization
Contact information
Practice address
554 BLOOMFIELD AVE, SUITE 301, BLOOMFIELD, NJ 07003-3307
(201) 791-7771
(201) 791-7337
Mailing address
554 BLOOMFIELD AVE, SUITE 301, BLOOMFIELD, NJ 07003-3307
(201) 791-7771
(201) 791-7337
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
Other
Enumeration date
09/23/2013
Last updated
09/23/2013
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