Provider Demographics
NPI:1669809547
Name:AESTHETIC,RECONSTRUCTIVE & HAND SURGERY, P.C.
Entity type:Organization
Organization Name:AESTHETIC,RECONSTRUCTIVE & HAND SURGERY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MANNY
Authorized Official - Middle Name:S
Authorized Official - Last Name:IYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-730-4171
Mailing Address - Street 1:5325 NORTHGATE DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-9411
Mailing Address - Country:US
Mailing Address - Phone:610-730-4171
Mailing Address - Fax:
Practice Address - Street 1:5325 NORTHGATE DR
Practice Address - Street 2:SUITE 202
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-9411
Practice Address - Country:US
Practice Address - Phone:610-730-4171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-08
Last Update Date:2013-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD032650E2082S0105X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E81843Medicare UPIN