Individual
VYACHESLAV PASTUKH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
1100 E CHESTNUT AVE, VINELAND, NJ 08360-5002
(856) 696-0108
Mailing address
1882 WYNNEWOOD DR, VINELAND, NJ 08361-6771
(856) 777-3968
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
26NJ01055900
NJ
Other
Enumeration date
09/27/2020
Last updated
09/27/2020
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