Provider Demographics
NPI:1316727530
Name:NOURI PLASTIC SURGERY LLC
Entity type:Organization
Organization Name:NOURI PLASTIC SURGERY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:M NOURI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-207-2575
Mailing Address - Street 1:16 ARCADIAN WAY STE C7
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1291
Mailing Address - Country:US
Mailing Address - Phone:973-200-2050
Mailing Address - Fax:
Practice Address - Street 1:16 ARCADIAN WAY STE C7
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1291
Practice Address - Country:US
Practice Address - Phone:973-200-2050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-04
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty