Provider Demographics
NPI:1033829924
Name:NESIVOS INC
Entity Type:Organization
Organization Name:NESIVOS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:TENDLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-966-4835
Mailing Address - Street 1:681 RIVER AVE STE 2C2D
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-5229
Mailing Address - Country:US
Mailing Address - Phone:732-534-7800
Mailing Address - Fax:
Practice Address - Street 1:681 RIVER AVE STE 2C2D
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-5229
Practice Address - Country:US
Practice Address - Phone:732-534-7800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)