| Organization Name: | SAMRA PLASTIC AND RECONSTRUCTIVE SURGERY LLC |
| NPI Number: | 1508804493 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NICOLE BISKUP (OFFICE MANAGER) |
| Mailing Address: | 733 N Beers St Suite U1 Holmdel |
| State: | NJ US |
| Postal Code: | 077331528 |
| Phone Number: | 7327392100 |
| Fax Number: | 7327391002 |
| NPI Enumeration Date: | 06/03/2006 |
| NPI Last Update Date: | 10/23/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 25MA07712600 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| 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. |