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General NPI Number Information
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NPI Number | 1538002332
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Entity Type | Organization
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Legal Business Name | COSMETIC SURGERY CENTER OF CHERY HILL, PC.
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Dates
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Enumeration Date | 04/14/2026
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Last Update Date | 04/14/2026
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Provider Practice Location Address
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Address Line | 1942 ROUTE 70 E
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City | CHERRY HILL
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State | NJ
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Zip | 08003-2118
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Country | US
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Telephone | 856-751-7550
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Fax | 856-751-7544
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Provider Business Mailing Address
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Address Line | 1942 ROUTE 70 E
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City | CHERRY HILL
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State | NJ
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Zip | 08003-2118
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Country | US
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Telephone | 865-751-7550
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Fax | 856-751-7544
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LYLE MARNIN BACK
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Credential | MD
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Telephone | 856-296-0990
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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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