Provider Demographics
NPI:1194949016
Name:AMBULATORY PLASTIC SURGERY FACILITY
Entity type:Organization
Organization Name:AMBULATORY PLASTIC SURGERY FACILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:C
Authorized Official - Last Name:MORELLO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-761-8667
Mailing Address - Street 1:10 CHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-5112
Mailing Address - Country:US
Mailing Address - Phone:914-761-8667
Mailing Address - Fax:914-761-5311
Practice Address - Street 1:10 CHESTER AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-5112
Practice Address - Country:US
Practice Address - Phone:914-761-8667
Practice Address - Fax:914-761-5311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical