NPI 1124656350 · live from the CMS NPI Registry
Ismail Abdul-Wahid, PA-C
Physician Assistant, Surgical in Brooklyn, NY. National Provider Identifier 1124656350, active.
NPI record
| NPI | 1124656350 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Surgical 363AS0400X |
| Practice location | 451 Clarkson Ave, Brooklyn, NY 11203 |
| Practice phone | 718-245-4687 |
| Mailing address | 724 E Henry St, Linden, NJ 07036 |
| Enumerated | April 1, 2020 |
| Last updated | April 24, 2022 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | — (NJ) |
| Student in an Organized Health Care Education/Training Program | 390200000X | — |
| Physician Assistant, Surgical primary | 363AS0400X | — (NY) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.