Organization · Type 2 NPI
Iconic Wellness Surgical Services
Surgical Physician Assistant · Glen Rock, NJ
NPI number
1316303035
Active
Practice location
139 Harristown Rd, Ste 205
Glen Rock, NJ 07452-3312
Fax (201) 444-1787
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | 25MP00262900 (NJ) |
Surgical Physician Assistant: Definition to come...
Another provider at this address
Other surgical physician assistant providers in Glen Rock
About NPI 1316303035
Iconic Wellness Surgical Services's National Provider Identifier is 1316303035, issued on Jan 11, 2016. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Glen Rock, NJ. The record was last updated on Jan 11, 2016.