Organization Name: | ALSONA HEALTHCARE SERVICES, LLC |
NPI Number: | 1235327479 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ALFRED R. TAWADROUS (PRES.) |
Mailing Address: | 679 Montgomery St Jersey City |
State: | NJ US |
Postal Code: | 073063324 |
Phone Number: | 2014337760 |
Fax Number: | 2014338010 |
NPI Enumeration Date: | 10/12/2007 |
NPI Last Update Date: | 10/12/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 25MA07842400 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |