Provider Demographics
NPI:1528216603
Name:MANHATTAN FACIAL SURGERY SUITES, PLLC
Entity Type:Organization
Organization Name:MANHATTAN FACIAL SURGERY SUITES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:BRENT
Authorized Official - Last Name:ROSENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-832-8535
Mailing Address - Street 1:115 E 61ST ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-8183
Mailing Address - Country:US
Mailing Address - Phone:212-832-8595
Mailing Address - Fax:212-421-0176
Practice Address - Street 1:115 E 61ST ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-8183
Practice Address - Country:US
Practice Address - Phone:212-832-8595
Practice Address - Fax:212-421-0176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic SurgeryGroup - Single Specialty