Provider Demographics
NPI:1144605007
Name:GREENWICH PLASTIC SURGERY CENTER
Entity Type:Organization
Organization Name:GREENWICH PLASTIC SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARGOLES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-769-1200
Mailing Address - Street 1:2 1/2 DEARFIELD DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-5335
Mailing Address - Country:US
Mailing Address - Phone:203-769-1200
Mailing Address - Fax:203-861-6621
Practice Address - Street 1:2 1/2 DEARFIELD DR
Practice Address - Street 2:SUITE 102
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-5335
Practice Address - Country:US
Practice Address - Phone:203-769-1200
Practice Address - Fax:203-861-6621
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-21
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical