is a Plastic And Reconstructive Surgery in Great Neck, New York. practices all healthcare services and medical treatments related to Plastic And Reconstructive Surgery. The NPI Number for is 1417114463. The last update date is .
's current location address is 560 Northern Blvd, Great Neck, New York. You can contact this provider via phone number 5167734200 and fax number 5167734202. The mailing address for is 560 Northern Blvd, Great Neck, New York. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 560 Northern Blvd, Great Neck, New York |
| Phone Number | 5167734200 |
| Fax Number | 5167734202 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1417114463 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 560 Northern Blvd |
|---|---|
| City | Great Neck |
| State | New York (NY) |
| Post Code | 110215118 |
| Phone Number | 5167734200 |
| Fax Number | 5167734202 |
Provider's Primary Taxonomy Detail
| Speciality | Plastic And Reconstructive Surgery |
|---|---|
| Taxonomy | 2086S0122X |
| Licence No | 238583 |
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Definition: A surgeon who specializes in plastic and reconstructive surgery. |
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