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Organization

ROSH OB-GYN ULTRASOUND OF NJ LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SUSAN BOUSKILA (CREDENTIALING MANAGER)
(718) 253-8111
Entity
Organization

Contact information

Practice address
1973 SPRINGFIELD AVE, MAPLEWOOD, NJ 07040-3435
(973) 996-2284
(212) 725-3738
Mailing address
PO BOX 231023, GREAT NECK, NY 11023-0023
(718) 253-8111
(718) 253-2333

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary

Other

Enumeration date
08/30/2016
Last updated
08/30/2016
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