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General NPI Number Information
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NPI Number | 1568605996
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Entity Type | Organization
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Legal Business Name | BEAUTIC INC.
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Dates
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Enumeration Date | 04/15/2009
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Last Update Date | 04/15/2009
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Provider Practice Location Address
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Address Line | 305 MAIN ST
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City | EAST AURORA
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State | NY
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Zip | 14052-1636
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Country | US
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Telephone | 716-655-7546
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Fax |
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Provider Business Mailing Address
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Address Line | 305 MAIN ST
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City | EAST AURORA
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State | NY
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Zip | 14052-1636
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Country | US
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Telephone |
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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. KULWANT BHANGOO
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Credential | M.D.
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Telephone | 716-655-7456
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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 | 120905
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License Number State | NY
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