Type | Legal entity | [sources] | |||
---|---|---|---|---|---|
Name | TYSHKOV, MICHAEL · TYSHOV, MICHAEL | [sources] | |||
Legal form | not available | [sources] | |||
Country | United States | [sources] | |||
NPI | 1902882038 | [sources] | |||
Sector | MD | [sources] | |||
Status | not available | [sources] | |||
Address | 87 SHREWSBURY DIRVE, LIVINGSTON, NJ 07039 · 87 SHREWSBURY DRIVE, LIVINGSTON, NJ 07039 | [sources] | |||
Last change | Last processed | First seen |
Medical providers disqualified from participating in New Jersey State's Medicaid program.
United States of America · OIFP
us-mednj-a6f4fb9429fc545566771ce3b378878134b8b747
· us-mednj-6465a3913c0ab8aeb9f7c0926ce2f632bf2899d8
For experts: raw data explorer
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Address | ||
---|---|---|
Full address | Country | |
87 SHREWSBURY DIRVE, LIVINGSTON, NJ 07039 | United States | |
87 SHREWSBURY DRIVE, LIVINGSTON, NJ 07039 | United States |