Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 22DI02304200 | NJ |
NPI | 1003060138 |
---|---|
Provider Name | Dr. Viktoria Sverdlov |
First Address | Fair Lawn, NJ 07410-6003 |
Second Address | Fair Lawn, NJ 07410-6003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2008 |
Last Update Date | 01/12/2010 |