Organization
WOMEN PELVIC SURGERY OF NORTH JERSEY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KHASHAYAR SHAKIBA MD (OWNER)
(203) 809-2724
Entity
Organization
Contact information
Practice address
330 RATZER RD, WAYNE, NJ 07470-7702
(203) 809-2724
(973) 773-2038
Mailing address
PO BOX 666, RIDGEWOOD, NJ 07451-0666
(203) 809-2724
(973) 773-2038
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
07/09/2010
Last updated
07/09/2010
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