Individual
DR. ROMAN N KOSIBOROD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
39-40 BROADWAY STE 1, FAIR LAWN, NJ 07410
(201) 509-8998
(973) 246-7120
Mailing address
387 VANCE AVE, FRANKLIN LAKES, NJ 07417-3016
(201) 982-4706
(973) 246-7120
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
25MB07566200
NJ
Other
Enumeration date
05/23/2005
Last updated
04/17/2019
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