Organization
AESTHETIC AND SURGICAL SPECIALIST, PC
Active
Organization
AESTHETIC AND SURGICAL SPECIALIST, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARISSA VAZQUEZ PA (OWNER)
(201) 485-1243
Entity
Organization
Contact information
Practice address
401 HAMBURG TPKE STE 204, WAYNE, NJ 07470-2139
(201) 485-1243
Mailing address
762 BARNSTABLE LN, FRANKLIN LAKES, NJ 07417-2900
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
07/30/2025
Last updated
07/30/2025
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