PL PMR Medical PC

Primary specialty

Neuromuscular Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081N0008X

License

25MA08695400 Issued in NJ

Legal business name

PL PMR MEDICAL PC

Practice address

1018 Palisade Ave
Suite 18
Fort Lee, NJ 07024-6300

Phone

(551) 574-2177

NPI assigned

Jun 6, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Lyudmila Poretskaya, M.D.

Title

President/ Owner

Phone

(551) 574-2177

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402012800000",
    "number": "1316350481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1018 PALISADE AVE",
            "address_2": "SUITE 18",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246300",
            "telephone_number": "551-574-2177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 PALISADE AVE",
            "address_2": "SUITE 18",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246300",
            "telephone_number": "551-574-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PL PMR MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-06",
        "last_updated": "2014-06-06",
        "status": "A",
        "authorized_official_last_name": "PORETSKAYA",
        "authorized_official_first_name": "LYUDMILA",
        "authorized_official_title_or_position": "PRESIDENT/ OWNER",
        "authorized_official_telephone_number": "551-574-2177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2081N0008X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Neuromuscular Medicine",
            "state": "NJ",
            "license": "25MA08695400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.