Provider Demographics
NPI:1043101223
Name:PJETROVIC, SANELA (MEDICAL AESTHETICIAN)
Entity type:Individual
Prefix:
First Name:SANELA
Middle Name:
Last Name:PJETROVIC
Suffix:
Gender:F
Credentials:MEDICAL AESTHETICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800A 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7215
Mailing Address - Country:US
Mailing Address - Phone:212-737-7500
Mailing Address - Fax:
Practice Address - Street 1:800A 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7215
Practice Address - Country:US
Practice Address - Phone:212-737-7500
Practice Address - Fax:212-737-7502
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYAEE-20-009412086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery