Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YS0123X | Facial Plastic Surgeon | 25MB09845000 | NJ |
Y | 207YS0123X | Facial Plastic Surgeon | 285291-1 | NY |
NPI | 1861780173 |
---|---|
Provider Name | Ruslan Zhuravsky |
First Address | Howell, NJ 07731-3301 |
Second Address | Howell, NJ 07731-3301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2011 |
Last Update Date | 15/01/2019 |