Provider Demographics
NPI:1235417809
Name:LE MEDSPA OF FLEMINGTON PC
Entity Type:Organization
Organization Name:LE MEDSPA OF FLEMINGTON PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:BUINEWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-806-2696
Mailing Address - Street 1:121 ROUTE 31
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-5744
Mailing Address - Country:US
Mailing Address - Phone:908-806-2696
Mailing Address - Fax:908-806-1715
Practice Address - Street 1:121 ROUTE 31
Practice Address - Street 2:SUITE 1000
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-5744
Practice Address - Country:US
Practice Address - Phone:908-806-2696
Practice Address - Fax:908-806-1715
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-29
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty