Provider Demographics
NPI:1720882236
Name:CENTRE FOR COSMETIC SURGERY & MEDICINE LLC
Entity type:Organization
Organization Name:CENTRE FOR COSMETIC SURGERY & MEDICINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABDOLLAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MALEKZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-994-8492
Mailing Address - Street 1:17644 COASTAL HWY
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-6257
Mailing Address - Country:US
Mailing Address - Phone:302-994-8492
Mailing Address - Fax:
Practice Address - Street 1:17644 COASTAL HWY
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-6257
Practice Address - Country:US
Practice Address - Phone:302-994-8492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical