Provider Demographics
NPI:1922165901
Name:CENTER FOR COSMETIC AND RECONSTRUCTIVE SURGERY
Entity Type:Organization
Organization Name:CENTER FOR COSMETIC AND RECONSTRUCTIVE SURGERY
Other - Org Name:THE ROBERT ZUBOWSKI CENTER FOR COSMETIC AND RECONSTRUCTIVE SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JANEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DIMARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-383-4155
Mailing Address - Street 1:1 SEARS DR
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-3515
Mailing Address - Country:US
Mailing Address - Phone:201-261-7550
Mailing Address - Fax:201-261-7515
Practice Address - Street 1:1 SEARS DR
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-3515
Practice Address - Country:US
Practice Address - Phone:201-261-7550
Practice Address - Fax:201-261-7515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ091275Medicare ID - Type Unspecified