Provider Demographics
NPI:1437199957
Name:NEMEROFSKY PLASTIC SURGERY CORPORATION
Entity Type:Organization
Organization Name:NEMEROFSKY PLASTIC SURGERY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:BECKER
Authorized Official - Last Name:NEMEROFSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:973-784-1024
Mailing Address - Street 1:PO BOX 1025
Mailing Address - Street 2:
Mailing Address - City:DENVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07834-0625
Mailing Address - Country:US
Mailing Address - Phone:973-784-1024
Mailing Address - Fax:973-710-0887
Practice Address - Street 1:16 POCONO RD
Practice Address - Street 2:SUITE 103
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2901
Practice Address - Country:US
Practice Address - Phone:973-784-1024
Practice Address - Fax:973-710-0887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07215500208200000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherTAX ID
NJ080886Medicare PIN
FL=========OtherTAX ID