Matsouk, Roman

Matsouk, Roman is an individual health care provider with primary practice located at 695 Us Highway 46 Suite 400A, Fairfield NJ 07004-1592. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Matsouk, Roman can be contacted via phone (973) 826-8080.

Contact Information

Primary practice address
695 Us Highway 46 Suite 400A Fairfield NJ 07004-1592
Phone: (973) 826-8080
Fax: (866) 309-3354
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 2SMP00172500 New Jersey
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 011450-1 New York
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 25MP00172500 New Jersey

Profile Details

NPI number 1558422766
LBN Legal business name Matsouk, Roman
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 12th, 2006
Last updated May 21st, 2019 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558422766 NPPES
New Jersey Other 116532ZJ5N PTAN SURGERY SERVICES
New Jersey MEDICAID 0429294 PTAN SURGERY SERVICES
New Jersey Other 116532YP69 PTAN SURGERY SERVICES

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