Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Aesthetic and Surgical Specialist, PC

Organization Surgical Physician Assistant · NPI 1669355020

Aesthetic and Surgical Specialist, PC provides Surgical Physician Assistant services in Wayne, New Jersey. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

401 Hamburg Tpke Ste 204
Wayne, NJ 07470-2139
Phone: (201) 485-1243
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X

Record details

NPI number1669355020
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Carissa Vazquez — Owner · (201) 485-1243
NPI enumeratedJuly 30, 2025
Last updated in NPPESJuly 30, 2025
Certification dateJuly 30, 2025
Mailing address762 Barnstable Ln, Franklin Lakes, NJ 07417-2900

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