| NPI | 1316303035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SADYK FAYZULAYEV Managing Member 201-444-1645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00262900) |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2016-01-11 |