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General NPI Number Information
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NPI Number | 1740219823
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Entity Type | Organization
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Legal Business Name | PARKER CENTER FOR PLASTIC SURGERY
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 122 E RIDGEWOOD AVE
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City | PARAMUS
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State | NJ
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Zip | 07652-4038
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Country | US
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Telephone | 201-967-1212
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Fax | 201-262-6270
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Provider Business Mailing Address
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Address Line | 27 EDITH ST
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City | OLD TAPPAN
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State | NJ
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Zip | 07675-7105
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL M PARKER
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Credential | M.D.
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Telephone | 201-967-1212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | MA36477
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License Number State | NJ
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