Organization · NPI-2

120 New York Ave Surgical PC

Plastic Surgery · Huntington, NY

NPI number1891355301
StatusActive
Last updated in NPPESJun 17, 2019

Details

NPI
1891355301
Entity type
Organization (NPI-2)
Legal business name
120 New York Ave Surgical PC
Organization subpart
No
Enumeration date
Jun 17, 2019
Last updated
Jun 17, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208200000X Plastic Surgery––Yes

Practice location

120 New York Ave
Huntington, NY 11743-2743

Phone 631-827-8159

Mailing address

120 New York Ave
Huntington, NY 11743-2743

Phone 631-827-8159

Authorized official

Mathew James
Patient Accounts
6318278159

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