=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477472181
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MILLENNIAL PLASTIC SURGERY PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/15/2026
-----------------------------------------------------
Last Update Date | 07/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 56 W 45TH ST FL 4
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10036-4215
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-421-7123
-----------------------------------------------------
Fax | 646-851-0423
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 56 W 45TH ST FL 4
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10036-4215
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-421-7123
-----------------------------------------------------
Fax | 646-851-0423
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. DAVID SHOKRIAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 516-209-7400
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2086S0122X
-----------------------------------------------------
Taxonomy Name | Plastic and Reconstructive Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------