MEDICARE: OVADIA PLASTIC SURGERY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician

General Provider Information

NPI Number	:	1699638502
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OVADIA PLASTIC SURGERY LLC

Provider Business Mailing Address
First Line	:	88 REGENT ST APT 1801
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-7619
Country	:	US
Telephone Number	:	516-698-4502
Fax Number	:	516-862-3317

Provider Business Practice Location Address
First Line	:	88 REGENT ST APT 1801
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-7619
Country	:	US
Telephone Number	:	516-698-4502
Fax Number	:	516-862-3317

Authorized Official
Title or Position	:	OWNER
Name	:	STEVEN OVADIA
Credential	:	MD
Telephone Number	:	516-698-4502

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/23/2025

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