Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2006-07-09
- Last updated
- 2012-05-29
Licenses
- License NJ
- 7009305
Location
- Practice location
- 456 PATERSON AVE
- City
- E RUTHERFORD NJ
- Postal code
- 070731315
- Phone
- 201-896-0001
Organization contact
- Name
- MORDY NISSEL
- Title
- President
- Phone
- 2018960001
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.