Healthcare Provider Details

I. General information

NPI: 1154723575
Provider Name (Legal Business Name): NORTHERN CENTER FOR PLASTIC SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2014
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 E PALISADE AVE FIRST FLOOR
ENGLEWOOD CLIFFS NJ
07632-3058
US

IV. Provider business mailing address

700 E PALISADE AVE FIRST FLOOR
ENGLEWOOD CLIFFS NJ
07632-3058
US

V. Phone/Fax

Practice location:
  • Phone: 201-820-5280
  • Fax: 201-608-5756
Mailing address:
  • Phone: 201-820-5280
  • Fax: 201-608-5756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number25MA09037700
License Number StateNJ

VIII. Authorized Official

Name: DR. AARON M CAPUANO
Title or Position: OWNER
Credential: MD
Phone: 201-820-5280