PLASTIC RECONSTRUCTIVE & COSMETIC SURGERY PC NPI 1023105947

NPI Information

NPI: 1023105947
Provider Name: PLASTIC RECONSTRUCTIVE & COSMETIC SURGERY PC
Classification: Surgery - 2086S0122X
Entity Type: Organization

Specialization: Plastic and Reconstructive Surgery

Address:
204 WORCESTER ST
WELLESLEY, MA
ZIP 02481
Phone: (781) 489-6218
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PLASTIC RECONSTRUCTIVE & COSMETIC SURGERY PC is a plastic and reconstructive surgery surgery in Wellesley, MA. The provider is a surgeon who specializes in plastic and reconstructive surgery. PLASTIC RECONSTRUCTIVE & COSMETIC SURGERY PC NPI is 1023105947. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

204 WORCESTER ST
WELLESLEY, MA
ZIP 02481-420
Phone: (781) 489-6218
Fax: (781) 489-6751

The provider's authorized official is Kenneth A Marshall .
The authorized official title is President and has the following contact phone number (781) 489-6228.

The enumeration date for this NPI number is 10/10/2006 and was last updated on 1/22/2013.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2086S0105X	Surgery	Surgery of the Hand			No
2	2086S0122X	Surgery	Plastic and Reconstructive Surgery			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	600215	OTHER	MASSACHUSETTS	TUFTS HEALTH PLAN
2	M12935	OTHER	MASSACHUSETTS	BCBS GROUP NUMBER
3	M12935	MEDICARE ID-TYPE UNSPECIFIED	MASSACHUSETTS	MEDICARE GROUP NUMBER

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

NPI Synchronization or Removal

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