Healthcare Provider Details

I. General information

NPI: 1396276994
Provider Name (Legal Business Name): YASMINA ZOGHBI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2017
Last Update Date: 07/24/2023
Certification Date: 05/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 EAST 98TH ST DEPT. OF SURGERY DIV. OF PLASTIC SURGERY BOX 1259
NEW YORK NY
10029-6501
US

IV. Provider business mailing address

5 EAST 98TH ST DEPT. OF SURGERY DIV. OF PLASTIC SURGERY BOX 1259
NEW YORK NY
10029-6501
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-5873
  • Fax: 212-534-2654
Mailing address:
  • Phone: 212-241-5873
  • Fax: 212-534-2654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number321349
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: