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General NPI Number Information
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NPI Number | 1346594686
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Entity Type | Organization
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Legal Business Name | PLASTIC & RECONSTRUCTIVE SERVICES,LLC
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Dates
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Enumeration Date | 11/08/2012
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Last Update Date | 11/08/2012
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Provider Practice Location Address
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Address Line | 333 N BEDFORD RD SUITE 230
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City | MOUNT KISCO
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State | NY
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Zip | 10549-1158
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Country | US
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Telephone | 914-752-6850
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Fax |
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Provider Business Mailing Address
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Address Line | 333 N BEDFORD RD SUITE 230
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City | MOUNT KISCO
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State | NY
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Zip | 10549-1158
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Country | US
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Telephone | 914-752-6850
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. SHARON DECHIARA
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Credential | M.D.
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Telephone | 914-752-6850
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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 |
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License Number State |
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