1861518730 NPI number — ASSOCIATES IN PLASTIC AESTHETIC SURGERY

Table of content: (NPI 1861518730)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861518730 NPI number — ASSOCIATES IN PLASTIC AESTHETIC SURGERY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASSOCIATES IN PLASTIC AESTHETIC SURGERY
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:
1861518730
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
522 E BROAD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTFIELD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07090-2116
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-654-6540
Provider Business Mailing Address Fax Number:
908-654-6504

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
522 E BROAD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTFIELD
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07090-2116
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-654-6540
Provider Business Practice Location Address Fax Number:
908-654-6504
Provider Enumeration Date:
03/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
APONTE
Authorized Official First Name:
VIDALIA
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLER
Authorized Official Telephone Number:
908-654-6540

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1458001 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2528002 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0977209 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0857807 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com