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ELEVATION PLASTIC SURGERY PC NPI 1073755443


NPI Information

NPI: 1073755443
Provider Name: ELEVATION PLASTIC SURGERY, PC
Classification: Plastic Surgery - 208200000X
Entity Type: Organization
Address:
60 TEMPLE ST
SUITE 4B
NEW HAVEN, CT
ZIP 06510
Phone: (203) 752-0015
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ELEVATION PLASTIC SURGERY, PC is a plastic surgery in New Haven, CT. The provider is a plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. ELEVATION PLASTIC SURGERY, PC NPI is 1073755443. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

60 TEMPLE ST
SUITE 4B
NEW HAVEN, CT
ZIP 06510-716
Phone: (203) 752-0015
Fax: (203) 772-2814

The provider's authorized official is Leo Ryo Otake .
The authorized official title is Medical Director and has the following contact phone number (203) 752-0015.

The enumeration date for this NPI number is 4/1/2009 and was last updated on 4/1/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208200000XPlastic Surgery046053CONNECTICUTYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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