Aesthetic Facial Plastic Surgery Center, INC.
Plastic Surgery, Plastic Surgery Within the Head and Neck in Media, PA. Organization (NPI-2).
NPI number1619163706
StatusActive
Last updated in NPPESSep 21, 2007
Details
- NPI
- 1619163706
- Entity type
- Organization (NPI-2)
- Legal business name
- Aesthetic Facial Plastic Surgery Center, INC.
- Organization subpart
- No
- Enumeration date
- Sep 21, 2007
- Last updated
- Sep 21, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2082S0099X | Plastic Surgery, Plastic Surgery Within the Head and Neck | MD068106L | PA | Yes |
Practice location
101 Chesley DrGeorgtown Building
Media, PA 19063-1761
Phone 610-565-6230 · Fax 570-386-3130
Mailing address
101 Chesley DrGeorgtown Building
Media, PA 19063-1761
Authorized official
Geraldine H Malloy
Credentialing Specialist
5703862366
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