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General NPI Number Information
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NPI Number | 1699003335
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Entity Type | Organization
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Legal Business Name | BETH AVIVA PREMINGER, MD PLLC
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Dates
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Enumeration Date | 11/18/2009
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Last Update Date | 01/16/2015
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Provider Practice Location Address
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Address Line | 969 PARK AVE # 1E
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City | NEW YORK
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State | NY
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Zip | 10028-0322
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Country | US
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Telephone | 212-706-1900
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Fax | 917-382-4126
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Provider Business Mailing Address
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Address Line | 969 PARK AVE # 1E
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City | NEW YORK
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State | NY
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Zip | 10028-0322
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Country | US
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Telephone | 212-706-1900
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Fax | 917-382-4126
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Authorized Official
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Title or Position | PHYSICIAN
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Name | BETH AVIVA PREMINGER
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Credential | MD
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Telephone | 212-706-1900
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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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