Provider Demographics
NPI:1396975827
Name:ANNA J.LAVOTSHKIN, M.D., P.C.
Entity type:Organization
Organization Name:ANNA J.LAVOTSHKIN, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:J
Authorized Official - Last Name:LAVOTSHKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:201-833-2288
Mailing Address - Street 1:757 TEANECK RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4241
Mailing Address - Country:US
Mailing Address - Phone:201-833-2288
Mailing Address - Fax:201-833-4441
Practice Address - Street 1:757 TEANECK RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4241
Practice Address - Country:US
Practice Address - Phone:201-833-2288
Practice Address - Fax:201-833-4441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-17
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service