Healthcare Provider Details

I. General information

NPI: 1477472181
Provider Name (Legal Business Name): MILLENNIAL PLASTIC SURGERY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56 W 45TH ST FL 4
NEW YORK NY
10036-4215
US

IV. Provider business mailing address

56 W 45TH ST FL 4
NEW YORK NY
10036-4215
US

V. Phone/Fax

Practice location:
  • Phone: 212-421-7123
  • Fax: 646-851-0423
Mailing address:
  • Phone: 212-421-7123
  • Fax: 646-851-0423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID SHOKRIAN
Title or Position: OWNER
Credential:
Phone: 516-209-7400