Individual
DR. NATALYA O AVANESOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
193 RT 9 SOUTH, SUITE 1 D, MANALAPAN, NJ 07726-3016
(732) 677-2505
(732) 677-2506
Mailing address
193 ROUTE 9 STE 1D, MANALAPAN, NJ 07726-3016
(732) 677-2505
(732) 677-2506
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
25MA07613800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0044407
—
NJ
Enumeration date
09/20/2005
Last updated
07/07/2023
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