Provider Demographics
NPI:1760757652
Name:PLASTIC SURGERY ASSOCIATES LLP
Entity Type:Organization
Organization Name:PLASTIC SURGERY ASSOCIATES LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:NOONAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-438-0505
Mailing Address - Street 1:455 PATROON CREEK BLVD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12206-5003
Mailing Address - Country:US
Mailing Address - Phone:518-438-0505
Mailing Address - Fax:518-438-4517
Practice Address - Street 1:455 PATROON CREEK BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12206-5003
Practice Address - Country:US
Practice Address - Phone:518-438-0505
Practice Address - Fax:518-438-4517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-12
Last Update Date:2013-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty