Provider Demographics
NPI:1528207792
Name:ELITE PLASTIC SURGERY, PC
Entity Type:Organization
Organization Name:ELITE PLASTIC SURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:SHAHBANO
Authorized Official - Last Name:AFRIDI
Authorized Official - Suffix:
Authorized Official - Credentials:MD, FRCS(C), FACS
Authorized Official - Phone:212-421-5100
Mailing Address - Street 1:110 E 66TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6504
Mailing Address - Country:US
Mailing Address - Phone:212-421-5100
Mailing Address - Fax:212-535-4651
Practice Address - Street 1:110 E 66TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6504
Practice Address - Country:US
Practice Address - Phone:212-421-5100
Practice Address - Fax:212-535-4651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY238296261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty