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Organization

WOMEN'S PELVIC SURGERY OF NORTH JERSEY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KHASHAYAR SHAKIBA M.D. (DIRECTOR)
(201) 301-2772
Entity
Organization

Contact information

Practice address
1 KALISA WAY STE 103, PARAMUS, NJ 07652-3508
(201) 301-2772
(201) 882-8422
Mailing address
PO BOX 666, RIDGEWOOD, NJ 07451-0666
(201) 301-2772
(201) 882-8422

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
25MA08288700
NJ

Other

Enumeration date
06/22/2011
Last updated
06/22/2011
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