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General NPI Number Information
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NPI Number | 1124327341
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Entity Type | Organization
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Legal Business Name | CAPITAL AREA PLASTIC SURGERY, PLLC
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Dates
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Enumeration Date | 03/28/2011
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Last Update Date | 04/04/2011
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Provider Practice Location Address
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Address Line | 377 CHURCH ST
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-8641
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Country | US
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Telephone | 518-203-2593
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Fax |
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Provider Business Mailing Address
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Address Line | 377 CHURCH ST
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-8641
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Country | US
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Telephone | 518-203-2593
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | DIANE KRITZ
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Credential |
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Telephone | 518-203-2593
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 256948
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License Number State | NY
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