Provider Demographics
NPI:1376840801
Name:SCULPT SURGICAL, LLC
Entity Type:Organization
Organization Name:SCULPT SURGICAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MEHUL
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMDAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-577-6050
Mailing Address - Street 1:53 WHITEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MORRIS PLAINS
Mailing Address - State:NJ
Mailing Address - Zip Code:07950-3333
Mailing Address - Country:US
Mailing Address - Phone:973-577-6050
Mailing Address - Fax:973-577-6049
Practice Address - Street 1:53 WHITEWOOD DR
Practice Address - Street 2:
Practice Address - City:MORRIS PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07950-3333
Practice Address - Country:US
Practice Address - Phone:973-577-6050
Practice Address - Fax:973-577-6049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-18
Last Update Date:2011-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08778700208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty