RAMAZI OTAROVICH DATIASHVILI

NEWARK, NJ
NPI1952466518
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2086S0122X Surgery, Plastic and Reconstructive Surgery
(Licence: NJ  25MA06921300)
Enumeration Date2006-12-26
Last Update Date2009-08-21
Business Address
-- RAMAZI OTAROVICH DATIASHVILI
90 BERGEN ST DOC 7200
NEWARK, NJ 07103-2425
Phone number: 973-972-1129
Mailing Address
-- RAMAZI OTAROVICH DATIASHVILI
30 BERGEN ST ADMC 12 1205
NEWARK, NJ 07107-3000
Phone number:
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