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PLASTIC & RECONSTRUCTIVE SURGERY OF CNY PC NPI 1851465496


NPI Information

NPI: 1851465496
Provider Name: PLASTIC & RECONSTRUCTIVE SURGERY OF CNY PC
Classification: Plastic Surgery - 208200000X
Entity Type: Organization
Address:
475 IRVING AVE
SUITE 320
SYRACUSE, NY
ZIP 13210
Phone: (315) 425-7822
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PLASTIC & RECONSTRUCTIVE SURGERY OF CNY PC is a plastic surgery in Syracuse, NY. 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. PLASTIC & RECONSTRUCTIVE SURGERY OF CNY PC NPI is 1851465496. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

475 IRVING AVE
SUITE 320
SYRACUSE, NY
ZIP 13210-756
Phone: (315) 425-7822
Fax: (315) 425-7885

The provider's authorized official is Kathy A Bidwell .
The authorized official title is Billing Supervisor and has the following contact phone number (315) 752-0141.

The enumeration date for this NPI number is 11/17/2006 and was last updated on 1/29/2015.


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 Surgery145420NEW YORKNo
22082S0105XPlastic SurgerySurgery of the Hand124408NEW YORKNo
32082S0105XPlastic SurgerySurgery of the Hand145420NEW YORKNo
4208200000XPlastic Surgery124408NEW YORKYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
101019447MEDICAIDNEW YORK
250840AMEDICARE PINNEW YORK
3D02185MEDICARE UPINNEW YORK
4B82965MEDICARE UPINNEW YORK

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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