| NPI | 1619122652 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA MONTEIRO Manager 718-477-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: NY 220593-1) |
| Additional Taxonomies | 174400000X Specialist |
| 207YS0123X Otolaryngology, Facial Plastic Surgery (Licence: NY 158614-1) | |
| 208200000X Plastic Surgery | |
| Enumeration Date | 2008-11-18 |
| Last Update Date | 2018-09-21 |