Provider Demographics
NPI:1639793508
Name:PARCELLS PLASTIC SURGERY
Entity Type:Organization
Organization Name:PARCELLS PLASTIC SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ALEXIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PARCELLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-281-6353
Mailing Address - Street 1:26 WILLOW DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE SILVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07739-1538
Mailing Address - Country:US
Mailing Address - Phone:201-281-6353
Mailing Address - Fax:
Practice Address - Street 1:655 SHREWSBURY AVE STE 207
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4151
Practice Address - Country:US
Practice Address - Phone:201-478-2555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-05
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1659662179Medicaid