Iconic Wellness Surgical Services
Physician Assistant, Surgical in Glen Rock, New Jersey
1316303035- Practice location
- 139 Harristown RD, Ste 205, Glen Rock, NJ 07452-3312
- Phone
- 201-444-1645
- Fax
- 201-444-1787
- Last updated
- January 11, 2016
Iconic Wellness Surgical Services is a healthcare organization based in Glen Rock, NJ. Iconic Wellness Surgical Services practices in Glen Rock, NJ. The NPI Number for Iconic Wellness Surgical Services is 1316303035 and holds a License No. 25MP00262900 (NJ). The current practice location address for Iconic Wellness Surgical Services is 139 Harristown RD, Ste 205, Glen Rock, NJ 07452-3312 and can be reached out via phone at 201-444-1645 and via fax at 201-444-1787.
Provider Profile Details
- NPI Number
- 1316303035
- Provider Name
- Iconic Wellness Surgical Services
- Provider Entity Type
- Organization
- Address
- 139 Harristown RD, Ste 205, Glen Rock, NJ 07452-3312
- Phone Number
- 201-444-1645
- Fax Number
- 201-444-1787
- Primary Taxonomy
- Physician Assistant, Surgical · 363AS0400X
- Organization Subpart
- No
- Authorized Official
- Mr. Sadyk Fayzulayev, PA · Managing Member · 201-444-1645
- Provider Enumeration Date
- January 11, 2016
- Last Update Date
- January 11, 2016
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 139 Harristown RD
Ste 205
Glen Rock, NJ 07452-3312 - City
- Glen Rock
- State
- New Jersey
- Zip
- 07452-3312
- Phone Number
- 201-444-1645
- Fax Number
- 201-444-1787
Provider Business Mailing Address Details
- Address
- 139 Harristown RD
Ste 205
Glen Rock, NJ 07452-3312 - City
- Glen Rock
- State
- NJ
- Zip
- 07452-3312
- Phone Number
- 201-444-1645
- Fax Number
- 201-444-1787
License Information
- License Number
- 25MP00262900
- License State
- NJ
- Taxonomy
- Physician Assistant, Surgical · 363AS0400X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Iconic Wellness Surgical Services?
The NPI number of Iconic Wellness Surgical Services is 1316303035. It was assigned on January 11, 2016 and is currently active in the NPPES registry.
What is the specialty of Iconic Wellness Surgical Services?
Iconic Wellness Surgical Services is registered under the primary taxonomy Physician Assistant, Surgical (code 363AS0400X), licensed in NJ under license number 25MP00262900.
Where does Iconic Wellness Surgical Services practice?
The practice location is 139 Harristown RD, Ste 205, Glen Rock, NJ 07452-3312. The office can be reached at 201-444-1645 (phone) or 201-444-1787 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1316303035 directly on the NPPES registry website.