Individual
VADIM SURIKOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5600 KENNEDY BLVD, SUITE 102, WEST NEW YORK, NJ 07093
(201) 866-3100
Mailing address
5600 KENNEDY BLVD, SUITE 102, WEST NEW YORK, NJ 07093
(201) 866-3100
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
25MB07578900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0076929
—
NJ
Enumeration date
03/26/2007
Last updated
02/08/2008
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