Provider Demographics
NPI:1205905064
Name:PENNSYLVANIA PLASTIC SURGERY ASSOCIATES
Entity type:Organization
Organization Name:PENNSYLVANIA PLASTIC SURGERY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:CAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:215-629-1866
Mailing Address - Street 1:600 EAGLEVIEW BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-1224
Mailing Address - Country:US
Mailing Address - Phone:610-280-6005
Mailing Address - Fax:610-280-6008
Practice Address - Street 1:601 WALNUT STREET
Practice Address - Street 2:SUITE 646W
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106
Practice Address - Country:US
Practice Address - Phone:215-629-1866
Practice Address - Fax:215-629-3711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0742215000OtherKEYSTONE HEALTH PLAN EAST
PA0742215000OtherKEYSTONE HEALTH PLAN EAST
PA0742215000OtherKEYSTONE HEALTH PLAN EAST