Provider Demographics
NPI:1730308693
Name:MADISON PLASTIC SURGERY P.C
Entity Type:Organization
Organization Name:MADISON PLASTIC SURGERY P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:TORNAMBE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:212-628-7600
Mailing Address - Street 1:46 E 82ND ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0305
Mailing Address - Country:US
Mailing Address - Phone:212-628-7600
Mailing Address - Fax:212-628-5799
Practice Address - Street 1:46 E 82ND ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0305
Practice Address - Country:US
Practice Address - Phone:212-628-7600
Practice Address - Fax:212-628-5799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY=========OtherEIN