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Individual

MR. ISMAIL ABDUL-WAHID

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
451 CLARKSON AVE, BROOKLYN, NY 11203-2054
(718) 245-4687
(718) 245-4689
Mailing address
724 E HENRY ST, LINDEN, NJ 07036-2132
(908) 967-3661
(718) 245-4689

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
NJ
363AS0400X
Surgical Physician Assistant
Primary
NY
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/01/2020
Last updated
04/24/2022
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