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General NPI Number Information
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NPI Number | 1306507694
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Entity Type | Organization
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Legal Business Name | NV MEDICAL AESTHETICS
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Dates
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Enumeration Date | 01/07/2022
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Last Update Date | 01/07/2022
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Provider Practice Location Address
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Address Line | 1777 HAMBURG TPKE STE 302
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City | WAYNE
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State | NJ
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Zip | 07470-5243
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Country | US
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Telephone | 973-773-2039
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Fax | 973-773-2038
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Provider Business Mailing Address
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Address Line | 1777 HAMBURG TPKE STE 302
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City | WAYNE
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State | NJ
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Zip | 07470-5243
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Country | US
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Telephone | 973-773-2039
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Fax | 973-773-2038
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | FRED YARAZAVI
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Credential |
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Telephone | 973-773-2037
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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