Healthcare Provider Details

I. General information

NPI: 1730437559
Provider Name (Legal Business Name): SALAS PLASTIC SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2012
Last Update Date: 02/08/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 OLD SHORT HILLS ROAD SUITE 501
WEST ORANGE NJ
07052-1080
US

IV. Provider business mailing address

65 LARKIN CIR
WEST ORANGE NJ
07052-1122
US

V. Phone/Fax

Practice location:
  • Phone: 973-731-9100
  • Fax: 973-731-9105
Mailing address:
  • Phone: 973-731-9100
  • Fax: 973-731-9105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ARYA SALAS
Title or Position: CEO
Credential: MD
Phone: 973-731-2000