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ICONIC WELLNESS SURGICAL SERVICES
NPI 1316303035
Physician Assistant - Surgical in Glen Rock, NJ

Active since January 11, 2016
139 HARRISTOWN RD, STE 205, GLEN ROCK, NJ 07452(201) 444-1645(201) 444-1787 Get Directions Write a Review

NPPES record last updated: January 11, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Iconic Wellness Surgical Services NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ICONIC WELLNESS SURGICAL SERVICES (NPI 1316303035) is a healthcare organization registered as a surgical in Glen Rock, New Jersey and active in the NPI registry since January 2016. The organization lists Sadyk Fayzulayev, Managing Member, as its authorized official.

NPPES Registry Identity

NPI1316303035
Entity TypeOrganization
Primary Taxonomy363AS0400X
Legal Business NameICONIC WELLNESS SURGICAL SERVICES
Location Address139 HARRISTOWN RD, STE 205Glen Rock, NJ 07452-3312
Mailing Address139 Harristown Rd, Ste 205Glen Rock, NJ 07452-3312 · (201) 444-1645 · Fax (201) 444-1787
Phone(201) 444-1645
Fax(201) 444-1787
Organization SubpartNo
Authorized OfficialSadyk FayzulayevManaging Member · (201) 444-1645
Enumeration DateJanuary 11, 2016
✔ NPI 1316303035 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License✔ Licensed in NJ · 25MP00262900
139 HARRISTOWN RD, Glen Rock, NJ 07452
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OPTIMAL CARE SURGICAL SERVICES
Physician Assistant (Surgical)
139 HARRISTOWN RD, 205
GLEN ROCK, NJ 07452
Bergen County (718) 431-5251

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Iconic Wellness Surgical Services's NPI number?

The NPI number for Iconic Wellness Surgical Services is 1316303035. It was assigned to this organization in the NPPES registry on January 11, 2016.

Where is Iconic Wellness Surgical Services located?

Iconic Wellness Surgical Services is located at 139 Harristown Rd Ste 205, Glen Rock, NJ 07452. The listed phone number is (201) 444-1645.

What is Iconic Wellness Surgical Services's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

When was this NPI record last updated?

The NPPES record for Iconic Wellness Surgical Services was last updated on January 11, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.