Individual
MR. WALID M ELZOMOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
506 6TH ST, BROOKLYN, NY 11215-3609
(718) 780-7700
Mailing address
309 WEDGEWOOD DR, PARAMUS, NJ 07652
(201) 483-3008
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
010232
NY
363AS0400X
Surgical Physician Assistant
Primary
25MP00140500
NJ
Other
Enumeration date
06/13/2006
Last updated
09/20/2019
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