Organization
MEDVANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAZALA DAVE (OWNER)
(484) 288-8130
Entity
Organization
Contact information
Practice address
214 OAK ST, RIDGEWOOD, NJ 07450-2511
(484) 288-8130
Mailing address
214 OAK ST, RIDGEWOOD, NJ 07450-2511
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
01/06/2019
Last updated
01/02/2021
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