Provider Demographics
NPI:1255367744
Name:PLASTIC SURGICAL ASSOCIATES
Entity type:Organization
Organization Name:PLASTIC SURGICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:E
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:412-681-5995
Mailing Address - Street 1:PO BOX 1961
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15230-1961
Mailing Address - Country:US
Mailing Address - Phone:412-826-1065
Mailing Address - Fax:412-826-1491
Practice Address - Street 1:4815 LIBERTY AVE
Practice Address - Street 2:SUITE 235
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2156
Practice Address - Country:US
Practice Address - Phone:412-681-5995
Practice Address - Fax:412-681-5772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007323250003Medicaid
PA086755Medicare ID - Type Unspecified