# CLIFTON PHYSICIAN ASSISTANT LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174981484
- **Authorized official:** DR. CHARLES G HADDAD M.D. (MEMBER/ MANAGER)
- **Authorized official phone:** (973) 779-7979

## Contact information

- **Practice address:** 1033 ROUTE 46, SUITE 102, CLIFTON, NJ 07013-2473
- **Practice address phone:** (973) 779-7979
- **Practice address fax:** (973) 779-7970
- **Mailing address:** 1033 ROUTE 46, SUITE 102, CLIFTON, NJ 07013-2473
- **Mailing address phone:** (973) 779-7979
- **Mailing address fax:** (973) 779-7970

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 25MP00383100 | NJ | Yes |

## Other

- **Enumeration date:** 02/01/2016
- **Last updated:** 02/01/2016