# PASSAIC MEDICAL GROUP PA

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

## Provider details

- **NPI number:** 1891122792
- **Authorized official:** RYTIS VALSKYS MD (PRESIDENT)
- **Authorized official phone:** (973) 692-9631

## Contact information

- **Practice address:** 87 BERDAN AVE, 2B, WAYNE, NJ 07470-3210
- **Practice address phone:** (973) 692-9631
- **Practice address fax:** (973) 692-1112
- **Mailing address:** 87 BERDAN AVE, 2B, WAYNE, NJ 07470-3210
- **Mailing address phone:** (973) 692-9631
- **Mailing address fax:** (973) 692-1112

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | 25MA08186700 | NJ | Yes |

## Other

- **Enumeration date:** 10/09/2013
- **Last updated:** 10/09/2013