Healthcare Provider Details

I. General information

NPI: 1639793508
Provider Name (Legal Business Name): PARCELLS PLASTIC SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2020
Last Update Date: 04/15/2025
Certification Date: 04/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 MORRIS AVE STE J
SPRING LAKE NJ
07762-1359
US

IV. Provider business mailing address

309 MORRIS AVE STE J
SPRING LAKE NJ
07762-1359
US

V. Phone/Fax

Practice location:
  • Phone: 732-945-6555
  • Fax:
Mailing address:
  • Phone: 732-945-6555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1659662179
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer

VIII. Authorized Official

Name: ALEXIS PARCELLS
Title or Position: MANAGING PARTNER
Credential:
Phone: 201-281-6353