Individual
ALEXANDER IAVOROV ATANASSOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
304 N PROSPECT ST, PHILLIPSBURG, NJ 08865-1345
(908) 514-9635
(908) 548-9250
Mailing address
304 N PROSPECT ST, PHILLIPSBURG, NJ 08865-1345
(908) 514-9635
(908) 548-9250
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
08/02/2019
Last updated
08/02/2019
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