Provider Demographics
NPI:1568772523
Name:ARTHRITIS ALLIANCE P.C.
Entity Type:Organization
Organization Name:ARTHRITIS ALLIANCE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TATYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRINCHENKO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:201-282-8356
Mailing Address - Street 1:363 STURBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-1562
Mailing Address - Country:US
Mailing Address - Phone:201-282-8356
Mailing Address - Fax:
Practice Address - Street 1:342 HAMBURG TPKE
Practice Address - Street 2:SUITE 201
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2162
Practice Address - Country:US
Practice Address - Phone:201-282-8356
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08252900207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty