Healthcare Provider Details

I. General information

NPI: 1043157969
Provider Name (Legal Business Name): ASKDRJASON LLC DBA CLIFFSIDE SKIN AND LASER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

663 PALISADE AVE STE 201
CLIFFSIDE PARK NJ
07010-3012
US

IV. Provider business mailing address

663 PALISADE AVE STE 201
CLIFFSIDE PARK NJ
07010-3012
US

V. Phone/Fax

Practice location:
  • Phone: 201-298-3650
  • Fax:
Mailing address:
  • Phone: 201-298-3650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State

VIII. Authorized Official

Name: JASON CHOUAKE
Title or Position: OWNER
Credential: MD
Phone: 201-298-3650