Provider Demographics
NPI:1487603007
Name:JOSIFOVSKI, PANDE VASIL (MD)
Entity type:Individual
Prefix:DR
First Name:PANDE
Middle Name:VASIL
Last Name:JOSIFOVSKI
Suffix:
Gender:M
Credentials:MD
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Other - Middle Name:
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Mailing Address - Street 1:123 HIGHLAND AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:GLEN RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07028-1527
Mailing Address - Country:US
Mailing Address - Phone:973-748-0678
Mailing Address - Fax:973-748-2808
Practice Address - Street 1:123 HIGHLAND AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:GLEN RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07028-1527
Practice Address - Country:US
Practice Address - Phone:973-748-0678
Practice Address - Fax:973-748-2808
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2010-06-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA02629900207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1696904Medicaid
NJ1696904Medicaid
NJE70427Medicare UPIN