Provider Demographics
NPI:1891346540
Name:BRONXVILLE PLASTIC SURGERY, PC
Entity Type:Organization
Organization Name:BRONXVILLE PLASTIC SURGERY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HIYAD
Authorized Official - Middle Name:
Authorized Official - Last Name:AL-HUSAINI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-776-0505
Mailing Address - Street 1:130 PONDFIELD RD STE 11
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-4016
Mailing Address - Country:US
Mailing Address - Phone:914-776-0505
Mailing Address - Fax:914-274-8120
Practice Address - Street 1:130 PONDFIELD RD STE 11
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-4016
Practice Address - Country:US
Practice Address - Phone:914-776-0505
Practice Address - Fax:914-274-8120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-24
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Single Specialty