Provider Demographics
NPI:1770932873
Name:ALEXANDER DRAKH MEDICAL PC
Entity type:Organization
Organization Name:ALEXANDER DRAKH MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAKH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:732-279-7656
Mailing Address - Street 1:PO BOX 5064
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08754-5064
Mailing Address - Country:US
Mailing Address - Phone:732-279-7656
Mailing Address - Fax:
Practice Address - Street 1:14 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6402
Practice Address - Country:US
Practice Address - Phone:732-279-7656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-09
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty