| Organization Name: | PLASTIC SURGERY OF SO CT |
| NPI Number: | 1053628883 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOSEPH B O'CONNELL (M.D.) |
| Mailing Address: | 208 Post Rd W Westport |
| State: | CT US |
| Postal Code: | 068804604 |
| Phone Number: | 2034540044 |
| Fax Number: | 2034548675 |
| NPI Enumeration Date: | 08/31/2010 |
| NPI Last Update Date: | 08/31/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 024727 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |