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1841427663
VALERY EUGENE FRADKOV
FAIR LAWN, NJ
NPI
1841427663
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker Clinical
(Licence: NJ 44SC05391100)
Enumeration Date
2009-06-19
Last Update Date
2009-08-10
Business Address
VALERY EUGENE FRADKOV LCSW
3100 BROADWAY
FAIR LAWN, NJ 07410-3963
Phone number: 917-582-1683
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Mailing Address
VALERY EUGENE FRADKOV LCSW
101 CHESTNUT ST
DUMONT, NJ 07628-3214
Phone number: 917-582-1683
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