Provider Demographics
NPI:1881219350
Name:YONKER PLASTIC SURGERY, LLC
Entity Type:Organization
Organization Name:YONKER PLASTIC SURGERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:VEPREK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-949-2711
Mailing Address - Street 1:875 OAK ST SE STE 4060
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3990
Mailing Address - Country:US
Mailing Address - Phone:503-561-7000
Mailing Address - Fax:
Practice Address - Street 1:875 OAK ST SE STE 4060
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3990
Practice Address - Country:US
Practice Address - Phone:503-561-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:YONKER PLASTIC SURGERY, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty