Provider Demographics
NPI:1992757082
Name:CONTEMPORARY PLASTIC SURGERY ASSOCIATES
Entity type:Organization
Organization Name:CONTEMPORARY PLASTIC SURGERY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KERTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-254-1919
Mailing Address - Street 1:579A CRANBURY RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5426
Mailing Address - Country:US
Mailing Address - Phone:732-254-1919
Mailing Address - Fax:732-254-0703
Practice Address - Street 1:579A CRANBURY RD
Practice Address - Street 2:SUITE 202
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5426
Practice Address - Country:US
Practice Address - Phone:732-254-1919
Practice Address - Fax:732-254-0703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA43679208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty