Organization
DAVID IOSEBASHVILI PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID IOSEBASHVILI O.D. (PRESIDENT)
(973) 589-7369
Entity
Organization
Contact information
Practice address
106 FERRY STR, NEWARK, NJ 07105
(973) 589-7369
(973) 589-2891
Mailing address
1315 ANDERSON AVE UNITE #28, FORT LEE, NJ 07024
(973) 589-7369
(973) 589-2891
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
06/18/2009
Last updated
06/18/2009
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