Organization Name: | COSMETIC AND RECONSTRUCTIVE SURGERY ASSOCIATES OF CONNECTICUT, PC |
NPI Number: | 1184021396 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK MANUEL MELENDEZ (PRESIDENT) |
Mailing Address: | 4 Corporate Dr Suite 288 Shelton |
State: | CT US |
Postal Code: | 064846211 |
Phone Number: | 2039358160 |
Fax Number: | 2039358162 |
NPI Enumeration Date: | 12/03/2014 |
NPI Last Update Date: | 12/03/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 052225 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |