person
Ramazi Otarovich Datiashvili
Plastic and Reconstructive Surgery Physician in Newark, New Jersey
NPI 1952466518

Ramazi Otarovich Datiashvili is a Plastic and Reconstructive Surgery Physician based in Newark, NJ and is specialized in Plastic and Reconstructive Surgery. Ramazi Otarovich Datiashvili practices in Newark, NJ. The NPI Number for Ramazi Otarovich Datiashvili is 1952466518 and holds a License No. 25MA06921300 (New Jersey).

The current practice location address for Ramazi Otarovich Datiashvili is 90 Bergen St, Newark, NJ and can be reached out via phone at 973-972-1129 and via fax at 973-972-2407. You can also correspond with Ramazi Otarovich Datiashvili through the mailing address at 30 BERGEN ST, NEWARK, NJ - 07107-3000 (mailing address contact number: ).

Location: 90 Bergen St, Newark, NJ, 07107-3000
person
Provider Profile Details
NPI Number
1952466518
Provider Name
Ramazi Otarovich Datiashvili
Credential
Provider Entity Type
Individual
Gender
Male
Address
90 Bergen St, Newark, NJ, 07107-3000
Phone Number
973-972-1129
Fax Number
973-972-2407
Provider Enumeration Date
12/26/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
8516006 05 NJ
institution
Provider Business Practice Location Address Details
Address
90 Bergen St
City
State
Zip
07103-2425
Phone Number
973-972-1129
Fax Number
973-972-2407
person
Provider Business Mailing Address Details
Address
90 Bergen St
City
State
Zip
07103-2425
Phone Number
973-972-1129
Fax Number
973-972-2407
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Surgery
Speciality
Plastic and Reconstructive Surgery
Taxonomy
License No.
25MA06921300 (New Jersey)
Definition
A surgeon who specializes in plastic and reconstructive surgery.
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