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General NPI Number Information
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NPI Number | 1962529412
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Entity Type | Organization
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Legal Business Name | EAST SIDE SURGERY, PC
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 105 E 73RD ST
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City | NEW YORK
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State | NY
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Zip | 10021-3502
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Country | US
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Telephone | 212-593-2900
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Fax | 718-672-4251
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Provider Business Mailing Address
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Address Line | 105 E 73RD ST
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City | NEW YORK
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State | NY
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Zip | 10021-3502
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Country | US
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Telephone | 212-593-2900
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Fax | 718-672-4251
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Authorized Official
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Title or Position | PRESIDENT
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Name | HOWARD T BELLIN
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Credential | MD
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Telephone | 212-288-4440
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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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