Organization
PRESTIGE HEALTH CENTER P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROMAN KOSIBOROD M.D. (MEDICAL DIRECTOR)
(973) 928-3840
Entity
Organization
Contact information
Practice address
385 LAKEVIEW AVE STE 4, CLIFTON, NJ 07011-4075
(973) 928-3840
(973) 928-3843
Mailing address
385 LAKEVIEW AVE STE 4, CLIFTON, NJ 07011-4075
(973) 928-3840
(973) 928-3843
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
25MB07566200
NJ
Other
Enumeration date
06/14/2016
Last updated
06/14/2016
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