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Organization

PL PMR MEDICAL PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LYUDMILA PORETSKAYA M.D. (PRESIDENT/ OWNER)
(551) 574-2177
Entity
Organization

Contact information

Practice address
1018 PALISADE AVE, SUITE 18, FORT LEE, NJ 07024-6300
(551) 574-2177
Mailing address
1018 PALISADE AVE, SUITE 18, FORT LEE, NJ 07024-6300
(551) 574-2177

Taxonomy

Speciality
Code
Description
License number
State
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
Primary
25MA08695400
NJ

Other

Enumeration date
06/06/2014
Last updated
06/06/2014
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