Individual
IRINA V. EFREMOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
675 HOES LN, UNIVERSITY BEHAVIORAL HEALTHCARE CENTER, PISCATAWAY, NJ 08854-5627
(732) 235-4402
(732) 235-3923
Mailing address
317 GEORGE ST, 3RD FLOOR, PROVIDER ENROLLMENT, NEW BRUNSWICK, NJ 08901-2008
(732) 235-6772
(732) 235-8347
Taxonomy
Speciality
Code
Description
License number
State
2084P0805X
Geriatric Psychiatry Physician
Primary
25MA068611
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8051402
—
NJ
Enumeration date
10/24/2006
Last updated
07/08/2007
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