Organization
PERITONIAL DIALYSIS ON NORTH AMERICA,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEXANDER M SWAN M.D (OWNER)
(732) 750-5555
Entity
Organization
Contact information
Practice address
1030 ST.GEORGE AVE, LOWER LEVEL 1, AVENEL, NJ 07001
(732) 750-5555
(732) 750-5550
Mailing address
1030 ST.GEORGE AVE, LOWER LEVEL 1, AVENEL, NJ 07001
(732) 750-5555
(732) 750-5550
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MA068150
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8974004
—
NJ
Enumeration date
07/07/2006
Last updated
12/28/2008
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