Provider Demographics
NPI:1891153722
Name:METROPOLITAN INTERVENTIONAL MEDICAL SERVICES P.C.
Entity Type:Organization
Organization Name:METROPOLITAN INTERVENTIONAL MEDICAL SERVICES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDR
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZAITSEV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-574-2070
Mailing Address - Street 1:PO BOX 4235
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07474-4235
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2818 31ST ST
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-1745
Practice Address - Country:US
Practice Address - Phone:973-574-2070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-06
Last Update Date:2016-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223544-2261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty