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General NPI Number Information
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NPI Number | 1366050387
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Entity Type | Organization
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Legal Business Name | CENTER FOR EYE AND FACIAL PLASTIC SURGERY
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Dates
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Enumeration Date | 07/15/2020
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Last Update Date | 01/13/2023
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Provider Practice Location Address
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Address Line | 35 CLYDE RD STE 104
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City | SOMERSET
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State | NJ
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Zip | 08873-5045
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Country | US
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Telephone | 609-608-0142
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Fax | 855-644-0469
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Provider Business Mailing Address
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Address Line | 35 CLYDE RD STE 104
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City | SOMERSET
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State | NJ
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Zip | 08873-5045
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Country | US
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Telephone | 609-608-0142
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Fax | 855-644-0469
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Authorized Official
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Title or Position | OWNER
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Name | SATHYADEEPAK RAMESH
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Credential | MD
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Telephone | 817-675-1465
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207WX0200X
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Taxonomy Name | Ophthalmic Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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