Provider Demographics
NPI:1750832499
Name:ALTMAN CENTER FOR AESTHETIC PLASTIC AND RECONSTRUCTIVE SURGERY
Entity Type:Organization
Organization Name:ALTMAN CENTER FOR AESTHETIC PLASTIC AND RECONSTRUCTIVE SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR MEDICAL BILLING
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:REIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-569-3334
Mailing Address - Street 1:570 SYLVAN AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632-3132
Mailing Address - Country:US
Mailing Address - Phone:201-569-3334
Mailing Address - Fax:201-569-3321
Practice Address - Street 1:570 SYLVAN AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ENGLEWOOD CLIFFS
Practice Address - State:NJ
Practice Address - Zip Code:07632-3132
Practice Address - Country:US
Practice Address - Phone:201-569-3334
Practice Address - Fax:201-569-3321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-18
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07298500208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty