Organization Name: | PMR MEDICAL PC |
NPI Number: | 1548544604 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LEONID SHAPIRO (MEDICAL DIRECTOR) |
Mailing Address: | 790 Bloomfield Ave First Floor Suite 1 Clifton |
State: | NJ US |
Postal Code: | 070121142 |
Phone Number: | 8556997246 |
Fax Number: | 7187669763 |
NPI Enumeration Date: | 10/06/2011 |
NPI Last Update Date: | 04/06/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MA66044 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |