1265811848 NPI number — SOOD CENTER FOR PLASTIC SURGERY, PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265811848 NPI number — SOOD CENTER FOR PLASTIC SURGERY, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SOOD CENTER FOR PLASTIC SURGERY, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265811848
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/28/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
199 NEW RD
Provider Second Line Business Mailing Address:
SUITE 31
Provider Business Mailing Address City Name:
LINWOOD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08221-2025
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-904-5390
Provider Business Mailing Address Fax Number:
609-904-5394

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
199 NEW RD
Provider Second Line Business Practice Location Address:
SUITE 31
Provider Business Practice Location Address City Name:
LINWOOD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08221-2025
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-904-5390
Provider Business Practice Location Address Fax Number:
609-904-5394
Provider Enumeration Date:
05/28/2015

Additional Information

Authorized Official

Authorized Official Last Name:
SOOD
Authorized Official First Name:
MOHIT
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
609-904-5390

Provider Taxonomy Codes

  • Taxonomy code: 261QA1903X , with the licence number:  25MB09088300 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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