Provider Demographics
NPI:1811501729
Name:HAMPTONS PLASTIC SURGERY, PLLC
Entity type:Organization
Organization Name:HAMPTONS PLASTIC SURGERY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:MARLENE
Authorized Official - Last Name:PFEIFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:631-653-6112
Mailing Address - Street 1:PO BOX 1609
Mailing Address - Street 2:
Mailing Address - City:QUOGUE
Mailing Address - State:NY
Mailing Address - Zip Code:11959-1609
Mailing Address - Country:US
Mailing Address - Phone:631-653-6112
Mailing Address - Fax:631-653-5899
Practice Address - Street 1:25 MONTAUK HWY STE 1
Practice Address - Street 2:
Practice Address - City:QUOGUE
Practice Address - State:NY
Practice Address - Zip Code:11959-4000
Practice Address - Country:US
Practice Address - Phone:631-653-6112
Practice Address - Fax:631-653-5899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty