Healthcare Provider Details

I. General information

NPI: 1336004852
Provider Name (Legal Business Name): MANHATTAN SURGICAL SERVICES PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

308 E 79TH ST # 1DEF
NEW YORK NY
10075-0998
US

IV. Provider business mailing address

308 E 79TH ST # 1DEF
NEW YORK NY
10075-0998
US

V. Phone/Fax

Practice location:
  • Phone: 212-339-2001
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: ASHLEY COLLINS
Title or Position: ADMINISTRATION
Credential:
Phone: 212-339-2001