Organization Name: | AESTHETIC SURGERY CENTER LLC |
NPI Number: | 1154766343 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | FREDRIC NEWMAN (PRESIDENT) |
Mailing Address: | 722 Post Rd Darien |
State: | CT US |
Postal Code: | 068204744 |
Phone Number: | 2036569999 |
Fax Number: | 2036550099 |
NPI Enumeration Date: | 05/02/2013 |
NPI Last Update Date: | 03/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA1903X |
License Number: | 0317 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CT |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Ambulatory Surgical |
Taxonomy Definition: |