| Grigory Rasin LLC | |
|
2143 Morris Ave Ste 108 Union NJ 07083-6021 | |
| (908) 686-4145 | |
| (908) 851-2128 |
| Full Name | Grigory Rasin LLC |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 2143 Morris Ave Ste 108, Union, New Jersey |
| Authorized Official Name and Position | Grigory S. Rasin (OWNER) |
| Authorized Official Contact | 9086864145 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grigory Rasin LLC 2143 Morris Ave Ste 108 Union NJ 07083-6021 Ph: (908) 686-4145 | Grigory Rasin LLC 2143 Morris Ave Ste 108 Union NJ 07083-6021 Ph: (908) 686-4145 |
| NPI Number | 1083159495 |
|---|---|
| Provider Enumeration Date | 12/21/2016 |
| Last Update Date | 01/11/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083159495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 25MA06556300 (New Jersey) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 25MA04227500 (New Jersey) | Primary |
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