Type not stated
Screen this subjectIVANOV ALEXANDER
Debarred entityUnited States. Named in 2 sanctions listings.
Sanctions and listings2
- Effective
- 15 Jun 2023
Official designation
New York State Office of the Medicaid Inspector GeneralUS New York State Medicaid ExclusionsUnited States
- Effective
- 15 Sep 2024
Official designation
New Jersey Office of the State ComptrollerUS New Jersey Ineligible Medicaid ProvidersUnited States
DISQUALIFICATION
Identifiers2
| Identifier | Number |
|---|---|
| ID number | 00205206 |
| NPI number | 1790825222 |
Other names1
Also known as1
IVANOV, ALEXANDER
Addresses1
178 WATER STREET, PERTH AMBOY, NJ 08861
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