Individual
TUSEEAF RATHORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
22 BALL ST, 2ND FLOOR, IRVINGTON, NJ 07111-3521
(201) 668-5016
Mailing address
22 BALL ST, 2ND FLOOR, IRVINGTON, NJ 07111-3521
(201) 668-5016
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
2000440
NJ
291U00000X
Clinical Medical Laboratory
31D2083671
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0370703
—
NJ
05
—
0464848
—
NJ
Enumeration date
09/23/2014
Last updated
04/27/2024
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