Konstantin Pertsovsky
Internist Family Doctor Neuromusculoskeletal Medicine (NMM)
510 Hamburg Tpke Wayne Commons, Suite 101
Wayne
, New Jersey 07470-2025
Konstantin Pertsovsky
Internist Family Doctor Neuromusculoskeletal Medicine (NMM)
510 Hamburg Tpke Wayne Commons, Suite 101
Wayne
, New Jersey 07470-2025
(201) 840-4081
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About
Features
Specialties
- Neuromusculoskeletal Medicine (NMM)
- Family Doctor
- Internist
Languages spoken
- English
Location
First Address
- Konstantin Pertsovsky
- 414 Lafayette Ave Apt.a
- Cliffside Park, NJ
- Zip : 07010-2024
- Fax : (201) 840-4081
- Phone : (201) 840-4081
Second Address
- Konstantin Pertsovsky
- 510 Hamburg Tpke Wayne Commons, Suite 101
- Wayne, NJ
- Zip : 07470-2025
- Fax : (973) 942-6009
- Phone : (973) 942-6005
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 214845 | NY |
| N | 207Q00000X | Family Doctor | 214845 | NY |
| Y | 207R00000X | Internist | 25MB07552900 | NJ |
| Y | 111NI0900X | Internist | 25MB07552900 | NJ |
National Provider Identifier
| NPI | 1306876602 |
|---|---|
| Provider Name | Konstantin Pertsovsky |
| First Address | Cliffside Park, NJ 07010-2024 |
| Second Address | Wayne, NJ 07470-2025 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 03/07/2006 |
| Last Update Date | 06/11/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0157376 | (05) | NJ |
| H07992 | (02) | NJ |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.