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CELESTIAL PLASTIC AND RECONSTRUCTIVE SURGERY NPI 1619479201


NPI Information

NPI: 1619479201
Provider Name: CELESTIAL PLASTIC AND RECONSTRUCTIVE SURGERY

Other Name: CELESTIAL PLASTIC SURGERY

Classification: Surgery - 2086S0122X
Entity Type: Organization

Specialization: Plastic and Reconstructive Surgery

Address:
2230 GODBY RD
COLLEGE PARK, GA
ZIP 30349
Phone: (404) 268-0828
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CELESTIAL PLASTIC AND RECONSTRUCTIVE SURGERY is a plastic and reconstructive surgery surgery in College Park, GA. The provider is a surgeon who specializes in plastic and reconstructive surgery. CELESTIAL PLASTIC AND RECONSTRUCTIVE SURGERY NPI is 1619479201. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Celestial Plastic Surgery.

The provider's business location address is:

2230 GODBY RD
COLLEGE PARK, GA
ZIP 30349-002
Phone: (404) 268-0828
Fax: (404) 393-1695

The provider's authorized official is Ruth Celestin .
The authorized official title is Plastic Surgeon, Owner and has the following contact phone number (770) 845-0696.

The enumeration date for this NPI number is 2/28/2018 and was last updated on 6/1/2022.


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
1208200000XPlastic SurgeryNo
2208200000XPlastic Surgery70539GEORGIANo
32086S0122XSurgeryPlastic and Reconstructive SurgeryYes

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
1003211917AMEDICAIDGEORGIA
2DZ9723OTHERRAIROAD MEDICARE PTAN
31972708899MEDICAIDNEW JERSEY

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: 5/5/2024

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