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Contact Information

TEIMOURAZ VASSILIDZE, MD
225 WILLIAMSON STREET
ELIZABETH, NJ07202
 Phone: 908-994-5204
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for TEIMOURAZ VASSILIDZE · (Male)

NPI Number 1649299553
Status Active
Credentials MD
Entity Individual
Enumeration date 07/19/2006
Last updated 06/05/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • NJ License # 25MA06904200
  • NY License # 291354
  • NJ Medicaid 7966806
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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