Provider Demographics
NPI:1407022072
Name:SOUTH SHORE COSMETIC SURGEONS LLC
Entity Type:Organization
Organization Name:SOUTH SHORE COSMETIC SURGEONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:SARNELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-678-4451
Mailing Address - Street 1:36 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-5768
Mailing Address - Country:US
Mailing Address - Phone:516-678-4451
Mailing Address - Fax:516-678-3762
Practice Address - Street 1:36 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:ROCKVILLE CENTRE
Practice Address - State:NY
Practice Address - Zip Code:11570-5768
Practice Address - Country:US
Practice Address - Phone:516-678-4451
Practice Address - Fax:516-678-3762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2009-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty