Organization
AVICENNA MEDICAL ARTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALEXANDER VEDER M.D (OWNER)
(646) 522-3664
Entity
Organization
Contact information
Practice address
660 TENNENT RD, SUITE 104, MANALAPAN, NJ 07726-3163
(646) 522-3664
(732) 831-6171
Mailing address
PO BOX 302, MANALAPAN, NJ 07726-0302
(646) 522-3664
(646) 522-3664
Taxonomy
Speciality
Code
Description
License number
State
202C00000X
Independent Medical Examiner Physician
25MA08792700
NJ
207L00000X
Anesthesiology Physician
25MA08792700
NJ
208VP0014X
Interventional Pain Medicine Physician
Primary
25MA08792700
NJ
Other
Enumeration date
12/07/2009
Last updated
03/03/2014
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