MEDICARE: MARISSA LAFER, MD P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician

General Provider Information

NPI Number	:	1417642851
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARISSA LAFER, MD P.C.

Provider Business Mailing Address
First Line	:	940 PARK AVE STE GFRE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10028-0311
Country	:	US
Telephone Number	:	212-486-1010
Fax Number	:

Provider Business Practice Location Address
First Line	:	940 PARK AVE STE GFRE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10028-0311
Country	:	US
Telephone Number	:	212-486-1010
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MARISSA LAFER
Credential	:	MD
Telephone Number	:	212-486-1010

Provider Enumeration Date	:	04/11/2023
Last Update Date	:	03/02/2024

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