Organization · Type 2 NPI
Aesthetic MD of Ny
Specialist · Southampton, NY
NPI number
1962857987
Active
Practice location
61 Main St, 2nd Floor
Southampton, NY 11968-4870
Fax (631) 661-0463
Mailing address
PO Box 621
Babylon, NY 11702-0621
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | 174108AN (NY) |
Specialist: 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.
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About NPI 1962857987
Aesthetic MD of Ny's National Provider Identifier is 1962857987, issued on Apr 27, 2016. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Southampton, NY. The record was last updated on Apr 27, 2016.