Individual
DR. PHILLIP ASHLEY WACKYM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
210 SOMERSET ST FL 11, DEPARTMENT OF HEAD AND NECK SURGERY, NEW BRUNSWICK, NJ 08901-2066
(732) 235-5530
(609) 991-6148
Mailing address
210 SOMERSET STREET, 11TH FLOOR, DEPARTMENT OF HEAD AND NECK SURGERY, NEW BRUNSWICK, NJ 08901
(732) 235-5530
(609) 991-6148
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
25MA09934900
NJ
207YX0901X
Otology & Neurotology Physician
Primary
25MA09934900
NJ
Other
Enumeration date
05/16/2006
Last updated
01/25/2026
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