Provider Demographics
NPI:1134735194
Name:AKESO WOUND INSTITUTE, LLC
Entity type:Organization
Organization Name:AKESO WOUND INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SABARINATH
Authorized Official - Middle Name:
Authorized Official - Last Name:MOOTHEDATHA PARAYIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-880-8072
Mailing Address - Street 1:5 SUMMIT AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-1271
Mailing Address - Country:US
Mailing Address - Phone:201-880-8072
Mailing Address - Fax:
Practice Address - Street 1:5 SUMMIT AVE STE 105
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1271
Practice Address - Country:US
Practice Address - Phone:201-880-8072
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-16
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty