Organization
WHOLEHEALTHMD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SERGEI KOCHLATYI MD (PRESIDENT)
(917) 974-7172
Entity
Organization
Contact information
Practice address
110 5TH ST, CRESSKILL, NJ 07626-2002
(917) 974-7172
(201) 313-8888
Mailing address
110 5TH ST, CRESSKILL, NJ 07626-2002
(917) 974-7172
(201) 313-8888
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
25MA08189600
NJ
Other
Enumeration date
05/02/2008
Last updated
06/02/2016
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