The Youth Fountain
The Youth Fountain provides Surgery Physician services in Freehold, New Jersey. Registered with an NPI since 2013.
- In the registry since
- 2013
Practice location Address checks out
501 Iron Bridge Rd Ste 9Freehold, NJ 07728-5304 Not confirmed with CMS for 11 years — call before visiting
Phone: (866) 514-0025
Fax: (732) 358-0524
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Surgery Physician (primary) | Taxonomy 208600000X |
|---|
Record details
| NPI number | 1598190506 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Emil Shakov — Owner · (866) 514-0025 |
| Other names | Youth Fountain |
| NPI enumerated | September 9, 2013 |
| Last updated in NPPES | November 25, 2014 |
| Mailing address | 501 Iron Bridge Rd, Suite 9, Freehold, NJ 07728-5304 |
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Dr. Emil Shakov, MD
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