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General NPI Number Information
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NPI Number | 1336657121
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Entity Type | Organization
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Legal Business Name | SOOD CENTER FOR PLASTIC SURGERY
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Dates
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Enumeration Date | 01/16/2018
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Last Update Date | 01/24/2018
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Provider Practice Location Address
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Address Line | 199 NEW RD STE 31
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City | LINWOOD
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State | NJ
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Zip | 08221-2025
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Country | US
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Telephone | 609-904-5390
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Fax |
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Provider Business Mailing Address
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Address Line | 199 NEW RD STE 31
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City | LINWOOD
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State | NJ
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Zip | 08221-2025
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Country | US
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Telephone | 609-904-5390
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | NANCY WEBER-DEPTOLA
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Credential |
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Telephone | 877-479-2622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 25MB09088300
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License Number State | NJ
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