Individual
ALEKSANDR MARTIROSOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
31-00 BROADWAY, 1ST FLOOR, FAIR LAWN, NJ 07410-3963
(201) 791-7771
(201) 791-7337
Mailing address
31-00 BROADWAY, 1ST FLOOR, FAIR LAWN, NJ 07410-3963
(201) 791-7771
(201) 791-7337
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MB06860100
NJ
207QA0401X
Addiction Medicine (Family Medicine) Physician
25MB06860100
NJ
Other
Enumeration date
01/24/2007
Last updated
10/18/2010
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