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1366547135
ELLEN VITIEVSKY
WEST NEW YORK, NJ
NPI
1366547135
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
207R00000X Internal Medicine
(Licence: NJ 25MA07786200)
Enumeration Date
2006-09-14
Last Update Date
2007-11-29
Business Address
-- ELLEN VITIEVSKY
5600 KENNEDY BLVD W SUITE 102
WEST NEW YORK, NJ 07093-1256
Phone number: 201-866-3100
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Mailing Address
-- ELLEN VITIEVSKY
PO BOX 7664
NORTH BRUNSWICK, NJ 08902-7664
Phone number: 201-866-3100
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