Pavel Odintsov APN

NPI 1073893178 - Nurse Practitioner - 363LA2200X

NPI Details
NPI 1073893178
Gender Male
Enumeration Date 08/19/2011
Last Updated 09/21/2015
Entity Type Individual
Active Over 5 years ago
Practice Location
10 FRANKLIN TPKE
MAHWAH NJ, 07430-1304, US
Phone (201) 529-0033
Fax (201) 529-5913
Business Location
20 GRAND ST
3RD FL
WARWICK NY, 10990-1035, US
Phone (845) 987-3906
Fax
Toxanomy
Taxonomy Code 363LA2200X
License State New York
License Number 306748
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According to our database, Mr. Pavel Odintsov APN NPI is 1073893178, taxonomy code is 363LA2200X and license number is 306748, license state is located at New York. Pavel Odintsov APN physically located at 10 Franklin Tpke, Mahwah NJ, 07430-1304. NPI Number Pavel Odintsov APN has the Individual type.

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1073893178 NPI number is provided on an as is basis without warranty of any kind. 1073893178 is maintained by the National Plan & Provider Enumeration System. The contents of Pavel Odintsov APN are for informational purposes only.