| Doctor Name: | DR. LUDMILA IVCHENKO |
| NPI Number: | 1720070345 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 25MA07409900 |
| Business Practice Address: | One Hospital Plaza Old Bridge, NJ - 088573087 |
| Business Phone Number: | 7323604019 |
| Business Fax Number: | |
| Mailing Address: | 66 West Gilbert Street, Suite 100 RED BANK |
| State: | NJ |
| Postal Code: | 077014918 |
| Phone Number: | 7322120060 |
| Fax Number: | 7322120061 |
| NPI Enumeration Date: | 08/19/2005 |
| NPI Last Update Date: | 02/22/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 25MA07409900 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |