Type not stated

IVANOV ALEXANDER

Debarred entity

United States. Named in 2 sanctions listings.

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Sanctions and listings2

  • Effective
    15 Jun 2023

    Official designation

    New York State Office of the Medicaid Inspector GeneralUS New York State Medicaid ExclusionsUnited States

    omig.ny.gov

  • Effective
    15 Sep 2024

    Official designation

    New Jersey Office of the State ComptrollerUS New Jersey Ineligible Medicaid ProvidersUnited States

    DISQUALIFICATION

    nj.gov

Identifiers2

IdentifierNumber
ID number00205206
NPI number1790825222

Other names1

Also known as1

IVANOV, ALEXANDER

Addresses1

  • 178 WATER STREET, PERTH AMBOY, NJ 08861

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