Provider Demographics
NPI:1821310483
Name:TOVBA CARE MEDICAL PC
Entity Type:Organization
Organization Name:TOVBA CARE MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDUARD
Authorized Official - Middle Name:
Authorized Official - Last Name:FUZAYLOV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-617-9176
Mailing Address - Street 1:5 WILTSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3570
Mailing Address - Country:US
Mailing Address - Phone:917-617-9176
Mailing Address - Fax:
Practice Address - Street 1:5 WILTSHIRE DR
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3570
Practice Address - Country:US
Practice Address - Phone:917-617-9176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-24
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty