Provider Demographics
NPI:1740455070
Name:NY FACIAL SURGICAL FACILITY, LLP
Entity type:Organization
Organization Name:NY FACIAL SURGICAL FACILITY, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MOSHE
Authorized Official - Middle Name:
Authorized Official - Last Name:EPHRAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-775-2800
Mailing Address - Street 1:3003 NEW HYDE PARK RD
Mailing Address - Street 2:SUITE 409
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1214
Mailing Address - Country:US
Mailing Address - Phone:516-775-2800
Mailing Address - Fax:516-775-0859
Practice Address - Street 1:3003 NEW HYDE PARK RD
Practice Address - Street 2:SUITE 409
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1214
Practice Address - Country:US
Practice Address - Phone:516-775-2800
Practice Address - Fax:516-775-0859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty