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Organization

DOCTOR PORETSKAYA MEDICAL PRACTICE, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LYUDMILA PORETSKAYA M.D. (OWNER)
(551) 574-2177
Entity
Organization

Contact information

Practice address
645 ELIZABETH AVE, ELIZABETH, NJ 07206-1131
(908) 662-2222
(908) 450-6150
Mailing address
1018 PALISADE AVE, APT 18, FORT LEE, NJ 07024-6300
(908) 662-2222
(908) 450-6150

Taxonomy

Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
25MA08695400
NJ

Other

Enumeration date
11/05/2014
Last updated
11/05/2014
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