Provider Demographics
NPI:1922265016
Name:PREMINGER, BETH AVIVA (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:AVIVA
Last Name:PREMINGER
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:969 PARK AVE # 1E
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-0322
Mailing Address - Country:US
Mailing Address - Phone:212-706-1900
Mailing Address - Fax:
Practice Address - Street 1:969 PARK AVE # 1E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0322
Practice Address - Country:US
Practice Address - Phone:212-706-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-18
Last Update Date:2015-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234154-1208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery