Provider Demographics
NPI:1184734204
Name:MOVSHOVICH PC
Entity type:Organization
Organization Name:MOVSHOVICH PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:MOVSHOVICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-943-0022
Mailing Address - Street 1:596 ANDERSON AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010
Mailing Address - Country:US
Mailing Address - Phone:201-943-0022
Mailing Address - Fax:201-313-7146
Practice Address - Street 1:596 ANDERSON AVE
Practice Address - Street 2:STE 101
Practice Address - City:CLIFFSIDE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07010
Practice Address - Country:US
Practice Address - Phone:201-943-0022
Practice Address - Fax:201-313-7146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA68142207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3H0761OtherBCBS OF NJ
5403626OtherAETNA
NJ7134909OtherCIGNA
NJ7964200Medicaid
1826249OtherUNITED HEALTHCARE
NJP1907446OtherOXFORD
P00014540OtherRAILROAD MEDICARE
NJ032984Q95OtherMEDICARE RENDERING NUMBER
NJ7134909OtherCIGNA
NJP1907446OtherOXFORD