OrganizationActive
Aesthetic and Surgical Specialist, PC
NPI 1669355020 · Surgical Physician Assistant · Wayne, NJ
Provider details
- NPI number
- 1669355020
- Entity type
- Organization
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Organization subpart
- No
- Authorized official
- Carissa Vazquez, Owner(201) 485-1243
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Established profile(54/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
Under 1 yr in registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
401 Hamburg Tpke Ste 204
Wayne, NJ 07470-2139
Phone: (201) 485-1243
Street-level locationGet directions
Mailing address
762 Barnstable Ln
Franklin Lakes, NJ 07417-2900
Registry dates
- Enumerated
- 2025-07-30
- Last updated
- 2025-07-30
- Certified
- 2025-07-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.