Surikov, Vadim
Surikov, Vadim is an sole proprietor health care provider with primary practice located at 5600 Kennedy Blvd Suite 102, West New York NJ 07093. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Surikov, Vadim can be contacted via phone (201) 866-3100.Contact Information
Primary practice address
5600 Kennedy Blvd Suite 102
West New York NJ 07093
Phone: (201) 866-3100
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pain Medicine | 2081P2900X | 25MB07578900 | New Jersey |
Profile Details
| NPI number | 1962529586 |
|---|---|
| LBN Legal business name | Surikov, Vadim |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 26th, 2007 |
| Last updated | Feb 8th, 2008 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962529586 | NPPES |
| New Jersey | MEDICAID | 0076929 |
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