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General NPI Number Information
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NPI Number | 1356889927
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Entity Type | Organization
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Legal Business Name | 120 EAST 56TH STREET, SUITE 800, MEDICAL OFFICE BASED SURGERY, P.C.
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Dates
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Enumeration Date | 02/03/2017
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Last Update Date | 02/03/2017
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Provider Practice Location Address
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Address Line | 120 E 56TH ST SUITE 800
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City | NEW YORK
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State | NY
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Zip | 10022-3607
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Country | US
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Telephone | 212-688-5955
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Fax |
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Provider Business Mailing Address
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Address Line | 120 E 56TH ST SUITE 800
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City | NEW YORK
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State | NY
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Zip | 10022-3607
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Country | US
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Telephone | 212-688-5955
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. YAEL HALAAS
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Credential |
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Telephone | 212-688-5955
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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 | 208455
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License Number State | NY
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