| NPI | 1639880677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRINA DOMANTOVSKY President 917-387-7834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2022-12-12 |
| Last Update Date | 2024-07-09 |