Organization
OMEGA MEDICAL GROUP, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LIGAYA PRYSTOWSKY MD (PRESIDENT)
(973) 667-4008
Entity
Organization
Contact information
Practice address
665 FRANKLIN AVE, NUTLEY, NJ 07110-1209
(973) 667-4008
Mailing address
633 FRANKLIN AVE, PMB 133, NUTLEY, NJ 07110-1209
(973) 667-4008
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MA041850
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1582003
—
NJ
Enumeration date
12/15/2008
Last updated
12/15/2008
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