Provider Demographics
NPI:1346594686
Name:PLASTIC & RECONSTRUCTIVE SERVICES,LLC
Entity Type:Organization
Organization Name:PLASTIC & RECONSTRUCTIVE SERVICES,LLC
Other - Org Name:SPA CHIARA WELLNESS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:DECHIARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-752-6850
Mailing Address - Street 1:333 N BEDFORD RD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-1158
Mailing Address - Country:US
Mailing Address - Phone:914-752-6850
Mailing Address - Fax:
Practice Address - Street 1:333 N BEDFORD RD
Practice Address - Street 2:SUITE 230
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-1158
Practice Address - Country:US
Practice Address - Phone:914-752-6850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-08
Last Update Date:2012-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty