Organization
BERGEN PHYSICAL & VEIN MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALEKSANDR MARTIROSOW MD (PRESIDENT)
(917) 450-5125
Entity
Organization
Contact information
Practice address
323 BERGEN BLVD, FAIRVIEW, NJ 07022-1334
(201) 283-4363
(551) 264-9558
Mailing address
323 BERGEN BLVD, FAIRVIEW, NJ 07022-1334
(201) 283-4363
(551) 264-9558
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
01/25/2021
Last updated
01/25/2021
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