Provider Demographics
NPI:1891181236
Name:AYDIN PLASTIC SURGERY PA
Entity Type:Organization
Organization Name:AYDIN PLASTIC SURGERY PA
Other - Org Name:AYDIN PLASTIC SURGERY PA PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEBIL
Authorized Official - Middle Name:BILL
Authorized Official - Last Name:AYDIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-288-8018
Mailing Address - Street 1:311 NORTH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605-2217
Mailing Address - Country:US
Mailing Address - Phone:914-288-8018
Mailing Address - Fax:201-820-0333
Practice Address - Street 1:311 NORTH ST
Practice Address - Street 2:SUITE 103
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-2217
Practice Address - Country:US
Practice Address - Phone:914-288-8018
Practice Address - Fax:201-820-0333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-13
Last Update Date:2017-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234202208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1073776589OtherINDIVIDUAL NPI