Vassilidze, Teimouraz

Vassilidze, Teimouraz is an individual health care provider with primary practice located at 225 Williamson Street , Elizabeth NJ 07202. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Vassilidze, Teimouraz can be contacted via phone (908) 994-5204.

Contact Information

Primary practice address
225 Williamson Street Elizabeth NJ 07202
Phone: (908) 994-5204
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 291354 New York
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 25MA06904200 New Jersey

Profile Details

NPI number 1649299553
LBN Legal business name Vassilidze, Teimouraz
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2006
Last updated Jun 5th, 2018 - about 7 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 1649299553 NPPES
New Jersey MEDICAID 7966806

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