Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. PHILLIP ASHLEY WACKYM, MD
ActiveOtolaryngic Allergy · NEW BRUNSWICK, NJ
Registration Details
- NPI Number
- 1720030315
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 16, 2006 (19.982470419229 yrs)
- Last Updated
- Jan 25, 2026
- Licenses
-
25MA09934900 (NJ)25MA09934900 (NJ)
Practice Information
- Address
-
210 SOMERSET ST FL 11DEPARTMENT OF HEAD AND NECK SURGERYNEW BRUNSWICK, NJ, 089012066Browse NJ providers · Browse ZIP 08901
- Phone
- 7322355530
- Fax
- 6099916148
- Primary Specialty
-
Otolaryngic Allergy
207YX0901X
- Additional Specialty
- Otolaryngic Allergy
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.