Provider Demographics
NPI:1538308846
Name:DAGAN COSMETIC SURGERY PC
Entity Type:Organization
Organization Name:DAGAN COSMETIC SURGERY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TAL
Authorized Official - Middle Name:
Authorized Official - Last Name:DAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-585-3242
Mailing Address - Street 1:217 GRAND ST
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4223
Mailing Address - Country:US
Mailing Address - Phone:212-585-3242
Mailing Address - Fax:212-585-3266
Practice Address - Street 1:5 E 83RD ST
Practice Address - Street 2:GROUNDFLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0401
Practice Address - Country:US
Practice Address - Phone:212-585-3242
Practice Address - Fax:212-585-3266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-10
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY236976174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
8M0351OtherPTAN
1013997980OtherNPI INDIVIDUAL #
8M0351OtherPTAN