Organization · Type 2 NPI
Northeast Plastic Surgery Center LLC
Plastic and Reconstructive Surgery Physician · Old Lyme, CT
NPI number
1932586682
Active
Practice location
5-1 Davis Road West, Suite 3
Old Lyme, CT 06371
Fax (718) 672-4251
Mailing address
12 Halls Rd, Unit 878
Old Lyme, CT 06371-7000
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Plastic and Reconstructive Surgery Physician Primary | 2086S0122X | 045607 (CT) |
Plastic and Reconstructive Surgery Physician: A surgeon who specializes in plastic and reconstructive surgery.
Other plastic and reconstructive surgery physician providers in Old Lyme
About NPI 1932586682
Northeast Plastic Surgery Center LLC's National Provider Identifier is 1932586682, issued on May 1, 2015. The primary taxonomy on file is Plastic and Reconstructive Surgery Physician (2086S0122X), and the practice location is in Old Lyme, CT. The record was last updated on May 1, 2015.