Healthcare Provider Details
I. General information
NPI: 1235055526
Provider Name (Legal Business Name): BIENSTOCK COSMETIC SURGERY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/29/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1015 CEDAR LN STE 203
WOODMERE NY
11598-1211
US
IV. Provider business mailing address
1015 CEDAR LN STE 203
WOODMERE NY
11598-1211
US
V. Phone/Fax
- Phone: 516-569-6311
- Fax:
- Phone: 516-569-6311
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DANIEL
BIENSTOCK
Title or Position: OWNER
Credential: MD
Phone: 516-569-6311