Petrishin, Timur
Petrishin, Timur is an individual health care provider with primary practice located at 2185 Lemoine Ave Ste 1G , Fort Lee NJ 07024-6030. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Petrishin, Timur can be contacted via phone (877) 959-8180.Contact Information
Primary practice address
2185 Lemoine Ave Ste 1G
Fort Lee NJ 07024-6030
Phone: (877) 959-8180
Fax: (866) 535-3188
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 37PC00825100 | New Jersey |
Profile Details
| NPI number | 1801521018 |
|---|---|
| LBN Legal business name | Petrishin, Timur |
| Credentials | PC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 21st, 2022 |
| Last updated | Jul 21st, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1801521018 | NPPES |
| New Jersey | Other | 37PC00825100 | STATE LICENSE |
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