Healthcare Provider Details

I. General information

NPI: 1902715428
Provider Name (Legal Business Name): SMSPLASTICSURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 PARK AVE
NEW YORK NY
10128-1202
US

IV. Provider business mailing address

11 MOUNTAIN RD
TENAFLY NJ
07670-2213
US

V. Phone/Fax

Practice location:
  • Phone: 212-660-4054
  • Fax: 212-660-4055
Mailing address:
  • Phone: 201-960-9203
  • Fax: 212-660-4055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: STEVEN MARK SULTAN
Title or Position: CEO
Credential: MD
Phone: 201-960-9203