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General NPI Number Information
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NPI Number | 1386485514
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Entity Type | Organization
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Legal Business Name | MANHATTAN PLASTIC SURGERY NYC, PLLC
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 568 PARK AVENUE
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City | NEW YORK
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State | NY
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Zip | 10065-7370
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Country | US
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Telephone | 352-325-5555
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Fax | 346-202-0106
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Provider Business Mailing Address
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Address Line | 568 PARK AVENUE
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City | NEW YORK
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State | NY
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Zip | 10065-7370
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Country | US
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Telephone | 352-325-5555
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Fax | 346-202-0106
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | JACK CAUDILL
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Credential |
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Telephone | 352-325-5555
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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 |
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License Number State |
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