Individual
DR. OLGA M VYSATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
146 FOREST AVE, WEST CALDWELL, NJ 07006-7970
(310) 498-0584
Mailing address
146 FOREST AVE, WEST CALDWELL, NJ 07006-7970
(310) 498-0584
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25NA02876500
NJ
Other
Enumeration date
01/03/2012
Last updated
05/06/2019
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