Provider Demographics
NPI:1386485514
Name:MANHATTAN PLASTIC SURGERY NYC, PLLC
Entity type:Organization
Organization Name:MANHATTAN PLASTIC SURGERY NYC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:
Authorized Official - Last Name:CAUDILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-325-5555
Mailing Address - Street 1:568 PARK AVENUE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7370
Mailing Address - Country:US
Mailing Address - Phone:352-325-5555
Mailing Address - Fax:346-202-0106
Practice Address - Street 1:568 PARK AVENUE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7370
Practice Address - Country:US
Practice Address - Phone:352-325-5555
Practice Address - Fax:346-202-0106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty