| NPI | 1568451391 |
|---|---|
| Other Name | COSMETIC PLASTIC RECONSTRUCTIVE SURGERY |
| Entity Type | Organization |
| Authorized Contact | MOHAMMAD B TABAIE Owner 315-492-5815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery |
| Enumeration Date | 2005-10-14 |
| Last Update Date | 2020-08-22 |